Three critical strategies for a smooth Medicaid pharmacy deployment
Key takeaways from a successful enterprise-level Medicaid Pharmacy Management launch
Bringing a state’s Medicaid Pharmacy Management solution online is incredibly complicated. Even with our teams’ decades of experience, no two cases are similar, and no two challenges can be solved the same way.
Complexity arises from each state’s unique regulatory landscapes, healthcare needs, clinical systems, claims data, system interdependencies, and population demographics. Moreover, integrating modern technology with existing infrastructures requires navigating considerable technical hurdles especially when cross-walking clinical databases such as Medispan and First Data Bank. Legacy systems, which many states still rely on, are often out of regulatory compliance and incompatible with newer software solutions, necessitating careful planning and innovative approaches to data integration, claims fidelity, and system interoperability.
Insights from MPM module rollout: Washington Healthcare Authority
Our team recently launched a MPM module for the Washington Health Care Authority’s Medicaid Management Information System (MMIS) to facilitate their transition to SaaS technology, empowering their teams to implement innovative healthcare purchasing strategies and policies that positively impact the lives of 2.1 million Washington residents.
Our innovative MPM module, housed within the Conduent Medicaid Suite (CMdS), provides our client with comprehensive features including user-friendly point of sale, prior authorization, rebate management, analytics, customer relationship management and retrospective drug review. Its design enables Conduent to train Health Care Authority staff to carry out essential tasks independently, reducing reliance on developer resources and accelerating implementation time and compliance with evolving business rules and regulatory changes.
As part of ongoing project debriefs, I asked our teams to assemble three key insights that we can share with other clients to help streamline their projects:
- Deploy the right leadership: Enterprise-level deployments can become disordered quickly if the right number of people — or types of people — aren’t properly planned. For this particular deployment, state validation and issue-tracking had to occur in parallel, adding a considerable degree of complexity. Because of this, we staffed two experienced project managers who could “tag team” tasks and delegate.
- Configure “war rooms” for critical tasks/decisions: During the Washington deployment, in-person conversations enabled thorough and rapid issue resolution. Those present in these predesignated rooms were able to make critical decisions based on immediate data. These rooms were then connected virtually via Microsoft Teams, allowing complete collaboration across different groups of specialized teams. A supply of snacks and beverages helped teams work through the night to ensure a successful and on-time deployment.
- Pace your status reports: For projects this complex, communication is key. It’s possible to under-communicate or communicate too frequently. Our teams were able to tailor a cadence of email updates that achieved their purpose without oversaturating others with information too frequently.
Embracing the unplanned
Many organizations report that their vendor relationships become increasingly complicated — and costly — when unexpected needs or challenges arise. In our industry, however, some degree of unplanned challenges are inevitable and can stem from a variety of causes, including technical issues, sudden changes in project scope or unexpected client concerns.
Conduent’s technical teams are trained to execute quick thinking and adaptability to effectively manage and mitigate potential impacts on the project's timeline, budget, and objectives. Our teams are seasoned in anticipating potential risks, establishing contingency plans and fostering open communication channels to address these surprises promptly, ensuring that projects remain on track despite the disruptions. Planning for challenges, big and small, is a critical component.
Our teams also focus on ensuring systems are user-friendly and accessible. This involves extensive user training and support to ensure that healthcare providers and beneficiaries can easily navigate the system.
By prioritizing user experience, we help states provide better service to their residents, ultimately leading to better health outcomes and satisfaction.
Ready to discover how Conduent Medicaid Pharmacy Management can help reduce costs, enhance compliance, and simplify processes for your organization? Visit us online to contact an expert.