WDH nears completion of major technology project

CHEYENNE – The Wyoming Department of Health (WDH) is nearing the end of an innovative, major, multi-year effort to improve and modernize key technology systems used by the department, health care providers, and program customers throughout the state.

WDH directly administers Wyoming Medicaid and Wyoming Kid Care CHIP, the state’s children’s health insurance program, providing health care and long-term care coverage to low-income children, parents, seniors, and people with disabilities . Approximately $550 million in claims are paid to health care providers each year for the services and care of program clients.

The modernization effort, called Wyoming Integrated Next Generation System (WINGS), involves replacing systems with the purchase and installation of eight component modules: vendor registration, request processing, data warehousing, reporting, health Program Management, Pharmacy Benefits Manager, Provider Call Center, Third Party Liability, System Integration, Electronic Visit Verification, and Care Case Management.

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“Several years ago, it became apparent that we needed to replace our outdated technology, which was inefficient to modify and had high maintenance and operating costs,” said Teri Green, state Medicaid agent and administrator. Principal of the Health Care Financing Division at WDH.

Rather than replacing the existing large and complex system with another similar system, WDH decided to offer components separately. “We didn’t want to end up with a giant system that would need a total replacement again in a few years. Our approach allows us to work with specialist vendors on the things they do best and allows for more continuous updates,” said Green.

Green noted that the typical “big bang approach” had a history of problems, cost overruns and delays in other states. “It was something we wanted to avoid,” she said.

With an overall budget of approximately $77 million, the WINGS effort was paid for with federal funds at 90% match rate, with state funds accounting for 10%. Planning for the project began in 2013 and the first system was installed in 2017. Six of the eight project components are in use; electronic visit verification begins next month and care case management is currently in procurement planning.

Designed to reduce the administrative burden on medical providers and reduce costs to the state, the recently completed Medicaid Benefits Management System (BMS) project is the largest WINGS module. The BMS system replaced the old Wyoming Medicaid Management Information System, which had been used since 1993 as the financial and accounting system for paying claims for medical, dental, vision, and waiver providers.

Jesse Springer, director of Medicaid’s technology and business operations unit at WDH, said the new components have several benefits for the state. “With the new BMS in particular, ongoing programs and federal and state health policy legislative changes will be delivered more efficiently and effectively to customers,” he said. “Wyoming vendors can also now enter payment processing requests in real time, allowing for quick fixes.”

“Setting up this new WINGS system required hundreds of thousands of hours of government personnel over several years for procurement, contracting, design, development, implementation , testing and stabilization,” Springer said. “State personnel took on project duties in addition to their normal work, and we thank each of them for the personal sacrifice and dedication that made this possible. The complexity and scope of the project required real teamwork with vendor staff and other partners. »

Technology, operations and consulting vendors involved include CNSI Inc., Deloitte, Change Healthcare, HHS Technology Group, Gannett Peak Technical Services, Happy Jack Consulting, Carebridge Health, Optum Health Services, Magellan Health, Nerthus Consulting, Sharp Decisions Consulting, Cedar Bridge Consulting, NTT data and public knowledge. Other state government partners include the Department of Family Services, Department of Workforce Services, Enterprise Technology Services, Office of the State Auditor, and Office of the Governor .

Jan Stall, Administrator of the Vendor and Benefits Management Unit at WDH, said: “As with the implementation of all complex technology projects, some issues are expected as we work with them over time. department undertakes to make the necessary corrections and improvements.

Wyoming Medicaid or Kid Care CHIP members experiencing issues should call (855) 294-2127 and select the most relevant option. Members can also email [email protected] and [email protected] if further assistance is needed. Suppliers with questions or issues may contact Supplier Services at 1-888-WYO-MCAD or [email protected] Providers can also email [email protected] and [email protected] for assistance.

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