NASCIO urges states to adopt federal Medicaid IT plan

The National Association of State Information Officers endorsed a common IT framework for states to use when modernizing their patchwork Medicaid information systems.

The Medicaid Information Technology Architecture (MITA) plan is a way states can decouple legacy systems and break down existing state government silos that have kept state governments from improving the management of health care programs and an abundance of health records.

State adherence to MITA 3.0, developed by the Centers for Medicare and Medicaid Services, is necessary for increasing the agility and interoperability of state Medicaid enterprises, according to a recent NASCIO report, “A Golden Opportunity for Medicaid Transformation: State CIOs and the MITA Framework.”


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This is an unprecedented time for health IT in the United States, and the goal of achieving lower costs, better health outcomes and system interoperability depends on an enterprise view like MITA, NASCIO officials said.

“Budgets are tight, and Medicaid expansion is going to be a major concern for the states,” said Doug Robinson, NASCIO executive director.

“State CIOs recognize there needs to be an enterprise approach that focuses on re-use and adaptability of emerging technologies to find potential savings,” Robinson said.

On March 28, 2012, CMS released the MITA 3.0 Framework, an updated collection of principles, models and guidelines for states to use when developing their own enterprise architectures.

The framework consists of three architecture segments – business, information and technical -- that will aid state Medicaid organizations in developing systems that share information and embrace emerging technologies, such as cloud computing.

States originally built Medicaid systems to satisfy the state Medicaid organizations’ own and federal business needs. The systems were not designed to interoperate seamlessly with other systems within the enterprise, let alone with external systems and applications.

States now need to extend current data and information activities to include data sharing, seamless integration, reuse and semantic operability at the enterprise level, while maintaining data quality and integrity, the report notes.

MITA’s data-management strategy helps coordinate information sharing for state Medicaid agencies with the goal of getting the right data to the right people at the right time.

The MITA framework is an evolving initiative that seeks to keep pace with trends such as Service-Orientated Architecture (SOA) and cloud computing, the report states.

States that combine cloud computing with SOA will enable the end-users to access the Medicaid enterprise using any Web browser.

“Anyone who has had the misfortune of losing a computing device or mobile phone understands how valuable it would be to have all of that saved information back at their fingertips through a simple log-in procedure,” the report says.

The report also pointed out that CMS has provided guidance on viable cloud deployment models for the state Medicaid agencies, saying the most practical options would be a federal community cloud or a hybrid cloud that would allow for "portions of the application solution to reside in a cloud environment,” according to the report.

NASCIO said in addition to the major technological change to MITA, this is also an unprecedented time for states to pursue funding for their Medicaid systems.

“There are substantial fiscal incentives for states to meet the seven standards and conditions for enhanced federal funding, but the benefit of state adherence to the principles of MITA will also be advantageous to citizens, the federal government and the vendor community,” NASCIO’s Robinson said.

About the Author

Rutrell Yasin is is a freelance technology writer for GCN.

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