What went wrong with Maine’s New Medicaid System? Case Study Questions
1. Information systems for Maine’s Department of Health and Human Services are extremely important. Without a functioning system in place the entire Medicaid system went completely haywire. There was a great negative impact felt by all involved when the newly chosen information system company, CNSI failed to deliver. Thousands of doctors were either underpaid or overpaid causing huge debt for the practice and state respectively. Claims were also so backed up in the system that some physicians had to close their doors to the patients causing them to suffer by not receiving treatment. Without an effective and accurate information system put in place Maine’s Department of Health and Human Services came completely undone.
4. In order to control the risk in the IT modernization project I would have first looked around at other states that had already begun to implement changes. I would have observed and researched what they were doing right and what needed improvements so that I was prepared for the task ahead. I also would have done some trial runs with the potential new system and tried to foresee any large scale problems. With this information I then would have been able to make a more reasonable Request for Proposal and possibly had more companies bidding on my job. This would have allowed for more options of companies with potentially more experience in turn leading to lesser risk.
5. If I were in charge of managing this project I would have done a lot more research to begin with. I would have gone to experts in the field of developing information systems and probably paid a higher price for the work to be done if it was going to be done right. I think it was a bad call to bring in a “no name” company to take on such a large scale overhaul. I also would have considered updating the system with something that was compatible with the old system instead of started from scratch. I don’t think the managers in charge of this thought through all of the people who would have to be trained in order to use these new standards. The system completely shutting claims out for data entry errors was a big problem. If employees would have been properly trained in the new system this could have been prevented. As the manger I would have never had a system that was so incompatible in the first place. Something more updated but still in the same realm of the old system would have made the transition much easier and a lot more straight forward.
1. Information systems for Maine’s Department of Health and Human Services are extremely important. Without a functioning system in place the entire Medicaid system went completely haywire. There was a great negative impact felt by all involved when the newly chosen information system company, CNSI failed to deliver. Thousands of doctors were either underpaid or overpaid causing huge debt for the practice and state respectively. Claims were also so backed up in the system that some physicians had to close their doors to the patients causing them to suffer by not receiving treatment. Without an effective and accurate information system put in place Maine’s Department of Health and Human Services came completely undone.
4. In order to control the risk in the IT modernization project I would have first looked around at other states that had already begun to implement changes. I would have observed and researched what they were doing right and what needed improvements so that I was prepared for the task ahead. I also would have done some trial runs with the potential new system and tried to foresee any large scale problems. With this information I then would have been able to make a more reasonable Request for Proposal and possibly had more companies bidding on my job. This would have allowed for more options of companies with potentially more experience in turn leading to lesser risk.
5. If I were in charge of managing this project I would have done a lot more research to begin with. I would have gone to experts in the field of developing information systems and probably paid a higher price for the work to be done if it was going to be done right. I think it was a bad call to bring in a “no name” company to take on such a large scale overhaul. I also would have considered updating the system with something that was compatible with the old system instead of started from scratch. I don’t think the managers in charge of this thought through all of the people who would have to be trained in order to use these new standards. The system completely shutting claims out for data entry errors was a big problem. If employees would have been properly trained in the new system this could have been prevented. As the manger I would have never had a system that was so incompatible in the first place. Something more updated but still in the same realm of the old system would have made the transition much easier and a lot more straight forward.
good one Kayal could have answered other questions too..
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