Read this if you are a state public health agency or a key interested party in state public health data systems design, development, and implementation.
In recent years, addressing disease risk through mitigation of Social Determinants of Health (SDOH) has become a shared goal between public health and the Centers for Medicare & Medicaid Services (CMS), bringing these agencies into the limelight for efforts to reduce healthcare costs, mitigate disease, and improve the health of the population. Efforts include leveraging Health Information Technology (HIT) and data sharing for electronic reporting of disease surveillance data, lab data, and health registry data. To do this, state agencies need to develop, enhance, or procure capable data systems and identify funding sources to support this work. With the number and size of data system enhancements needed and the fluctuations of public health funding, public health agencies need long-term, sustainable funding sources.
CMS policies and initiatives such as Electronic Health Record (EHR) Incentives, 21st Century Cures Act, Promoting Interoperability, and Medicaid Enterprise Systems (MES) are consistently, and sustainably funded through federal allocations to support HIT design, development, and implementation. When state Medicaid programs and public health agencies are able to identify shared goals and electronic reporting needs, joint efforts can tap into the same federal funding sources used by CMS to support the design, development, and implementation of public health data systems. State public health agencies who want or need to leverage this opportunity for federal funding will need to build or strengthen partnerships with their state Medicaid offices to learn more about applying for funding by submitting an updated Advance Planning Document (APD).
What is the Medicaid Enterprise System (MES)?
The MES is a modernized, state-based Medicaid Management Information System (MMIS) that uses modules to support enterprise-level systems interoperability. The MES is designed to help states efficiently manage and deliver Medicaid-funded services to their eligible populations and streamline interoperability across healthcare providers and regulatory agencies, including public health agencies. The development and adoption of the MES is part of CMS’s Promoting Interoperability Program.
The Promoting Interoperability Program and the development of the MES modules are built upon past programs for healthcare provider EHR incentives. These programs funded certified EHR system enhancements to electronically report health and billing information to state and federal agencies. As part of Promoting Interoperability, the reporting requirements have been updated to include electronic health information exchange and exchanging data with public health agencies. For calendar year 2023, CMS-certified systems are required to report on four scored objectives and their measures:
- Electronic prescribing
- Health Information Exchange (HIE)
- Provider to Patient Exchange
- Public Health and Clinical Data Exchange
The Public Health and Clinical Data Exchange objective requires that eligible hospitals and CMS-qualified providers actively engage with a public health agency or clinical data registry to submit electronic public health data. Data submission requirements for the Public Health and Clinical Data Exchange Objective may include the following:
- Immunization registry reporting
- Syndromic surveillance reporting
- Specialized registry reporting for either public health registries or clinical registries
- Electronic reportable laboratory results reporting
- Electronic case reporting
- Funding public health systems development
With the addition of the Public Health and Clinical Data Exchange objective, healthcare providers and state agencies are eligible for federal funding to support HIT systems design, development, and implementation. While several public health infrastructure and data modernization funding opportunities are available, MES federal funding can be leveraged to cover the costs of system enhancement, thus freeing up other funding sources to support modernized data management and use. As an example, MES funding can support immunization registry development while public health infrastructure funding supports data visualization tools and integration.
To apply for federal funding, state public health agencies will need to partner closely with their state Medicaid offices to understand their current and past APD processes, submissions, and approvals. Collaboration between Medicaid offices and state public health agencies is critical for this process since the APD submission and approval process is managed by CMS regional offices. The public health field is plagued by siloed programs and data systems that challenge collaboration efforts. Cross-agency collaboration between public health and Medicaid can be an additional challenge, but not one that cannot be overcome.
If you have any questions, please contact BerryDunn’s Public Health or Medicaid consulting teams for Public Health and/or Medicaid Agencies. We’re here to help!