Healthcare IT

Many of our team members were at the state and federal government in 2009 when the HITECH Act was enacted and implemented. HITECH ushered in an era of state and federal programs, guidance, and investments to support a new age of digital health services.

Nearly a decade later, we are still working hard to support the states, territories, and federal government in ongoing program operations. Outside the government, we have different tools, but we are still accomplishing the same goals. We seek technological sophistication to support delivery system reform that pays for improvements in outcomes.

Our team has expertise in the following Health IT services:

Medicaid/Medicare/CHIP Enterprise

HealthTech Solutions consultants specialize in Centers for Medicare and Medicaid Services (CMS) programs and health information technology. Our team has decades of experience with a full range of enterprise systems including Medicaid Management Information Systems (MMIS), state level registries (SLR), eligibility systems, electronic health records (EHR), EHR Incentive Payment systems, Medicaid Information Technology Architecture (MITA) Assessments, and pharmacy benefit management systems. We have worked with clients across the country, including states and Fortune 500 companies, to design, implement, and improve their programs.

Our extensive experience in Medicaid enterprise systems operations includes:

  • MMIS systems development, conversion, and MMIS Certification
  • MITA assessment
  • Claims (institutional, medical, dental, pharmacy including 837 and National Council for Prescription Drug Programs [NCPDP] formats), financial, Third Party Liability (TPL), Management and Administrative Reporting (MAR), Surveillance and Utilization Review (SUR), and Early and Periodic Screening, Diagnosis, and Treatment (EPSDT) subsystems
  • ICD-10
  • Pharmacy
  • Managed care

Managed Care Programs

Our consultants average more than ten years’ experience working with Managed Care Organizations (MCOs) at the state or company level. We have worked alongside both states and top 25 MCOs, and we understand the challenges of changing federal requirements with pressures for higher levels of service. We offer a full range of consulting services from provider networks to operations and technical assistance, and our goal is to help our clients succeed at every level.

Electronic Health Records

HealthTech Solutions is a recognized national leader in Medicaid Electronic Health Record (EHR) Incentive Programs. We provide EHR technical assistance for CMS as part of the Medicaid EHR Team (MeT) including developing the Stage 2 Audit Toolkit and auditing training manuals, conducting the Auditing Community of Practice, and researching questions and issues posed by state Medicaid agencies. Working with CMS has given our team a nationwide perspective of the best practices being employed by states. Our consultants also have years of field experience with EHR Provider Incentive Program post-payment Meaningful Use audits. Our combination of Medicaid experience, familiarity with state agency staff, and hands-on knowledge in EHR programs gives us a unique understanding of the challenges and opportunities many agencies face.

HITECH Program (including “Meaningful Use”) Compliance

Our senior consulting staff members have worked in and alongside many federal departments, including the Centers for Medicare and Medicaid Services, the Office of Management and Budget (OMB), and the White House. We have direct work experience on more than 50 different types of federal grants, loans, and programs totaling over $3 billion dollars. We have collaborated with CMS and other federal agencies for understanding and implementing federal requirements such as grant and program reporting including Office of Management and Budget Circular A-133; Generally Accepted Government Auditing Standards (GAGAS); Health Insurance Portability and Accountability Act (HIPAA); Affordable Care Act (ACA); CMS Medicaid Enterprise Systems; Electronic Medical Records (EMR); Health Information Exchange (HIE); Health Benefit Exchange (HBE); Advance Planning Documents (APD); electronic transactions implementation (4010 and 5010); National Correct Coding Initiative (NCCI); Medicaid Statistical Information Systems (MSIS/T-MSIS); and Medicaid Information Technology Architecture (MITA).

Health Information Exchange

Our consultants bring first-hand experience in working within numerous statewide Health Information Exchanges (HIE) and Regional Health Information Organizations (RHIO). We are well versed in the State HIE Cooperative Agreement Program and the requirements of the Office of the National Coordinator for Health Information Technology. In addition, we have direct experience launching a nationally recognized, fully operational statewide HIE. We provide strategic consulting services in planning, implementation, deployment, training, and upgrade assistance to a number of states across the country.

Health Benefit Exchange

We offer in-depth knowledge of health care reform and the eligibility process. Our team provides state agencies with open enrollment operational support and training and delivers recommendations regarding insurance affordability programs, cost sharing reductions, eligibility rules, and processing. Our consultants assist clients with all aspects of the enrollment and eligibility process including exchange navigators, application counseling, call center support, appeals, and systems processing. We partner with clients to keep pace with a changing regulatory environment with increasing demands for services.

Human Services

Our human services and public health experts offer in-depth knowledge of programs including immunization registries, clinic management systems, state laboratory services, child welfare, elder and disabled adult care, nutrition assistance, behavioral health, home health, and Women, Infants and Children (WIC). We have detailed knowledge of major systems including Electronic Benefit Transfer (EBT), vital statistics systems, case management systems, and the National Electronic Disease Surveillance System (NEDSS). We understand the need to meet federal and state program goals while striving for continuous improvement in health services and outcomes.