The technology upon which most states run their Medicaid programs is old, clunky and slow. To make matters worse, the expansion of Medicaid in a number of states under the Affordable Care Act has only put more pressure on these aging systems. Now nearly a quarter of states are looking to modernize them, according to the Centers for Medicare and Medicaid Services. But officials aren’t eager to risk a lot of money on another system that will be old, clunky and slow by the time it’s completed.
For decades, states have built their Medicaid Management Information Systems (MMIS) all at once -- and that makes sense. After all, a single, tightly integrated computer system seems like it would be the best way to run one of state government’s biggest and most complex programs. This big-bang approach, however, has a couple of serious flaws.