This post was originally published on the blog of the Human Services IT Advisory Group (HSITAG).
In the early months of the Biden Administration as the United States makes progress in the battle against COVID-19, APHSA and HSITAG outline priorities on how to modernize information technology systems—from a health and human services perspective—to help federal, state, and local agencies deliver benefits and services to citizens.
Broadly speaking, the main challenge to modernizing the delivery of services to individuals and families experiencing financial hardship has been the siloed and misalignment of programs, including interoperability gaps and disparate federal funding sources. Not surprisingly, the pandemic has strained the underlying IT systems impacting the timely delivery of program benefits, underscoring the need for immediate investments and alignments to critical systems.
There is a disconnect between how programs are funded and how state and local agencies deliver services. For example, Medicaid IT systems are reimbursed at 90 percent federal financial participation (FFP). All other health and human services systems, however, receive either significantly lower FFP or none at all.
We want our systems to be human centered, allowing people access to all the supports they need without navigating administratively burdensome and redundant processes. Integrated eligibility systems should work seamlessly across programs to deliver benefits and supports, but siloed funding and misaligned program rules create artificial boundaries that make this goal difficult to achieve, adding unnecessary costs and complications.
Based on our knowledge of social determinants of health, the conditions in the places where people live, learn, work, and play have an impact on a wide range of health risks and outcomes. As such, solely providing Medicaid is not sufficient to improve health outcomes; other programs need funding to modernize the IT systems to create a comprehensive support structure to holistically address the needs of families.
Therefore, enhanced federal funding (90%) for all systems addressing the social determinants of health alongside Medicaid should be modernized consistent to the Medicaid funding model. Along with funding, integrated and consistent guidance on system infrastructure and data sharing will build up the public data infrastructure and analytics modernization to address the impacts of COVID in the short-term and present real solutions to cutting the health care cost curve over time.
We have seen how the pandemic has permanently changed the way people interact with services and we need to be investing in the next wave of system modernization that engages families in the ways that meet them where they are, in such areas as telehealth, online purchasing, mobile applications, and virtual wallets.
To be sure there were many difficulties during the past year. Yet state and local agencies rose to the challenge in extraordinary circumstances to support communities during the pandemic. Technology constraints dealt them a tough hand to work with, but in spite of this, there were some amazing efforts to rise to the occasion. Investments in technology are investments in a more resilient future in times of crisis.
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