Lagging Health Insurance Exchange Glitches Leave Major Medicaid Improvements in Limbo

Broadcast on Vermont Public Radio

More than a third of Vermont’s population is enrolled in Medicaid. Their health care claims every year number in the millions, and those claims add up to well over $1 billion — on par with the size of Vermont’s General Fund, or even bigger.

But, like a lot of the state government’s technology, the IT system the Medicaid program runs on is really old: 30 years old.

It still works, but not very efficiently. Reports on those millions of Medicaid claims are vulnerable to human error, and producing them is time-consuming. So, the Medicaid Management Information System, or MMIS, is inefficient by modern standards.

It also doesn’t allow the state Medicaid office to be as effective as it could be in managing care for the roughly 225,000 adults and children enrolled in the program.

The IT upgrade intended for the Medicaid system already had faced years of delays before Vermont’s health insurance exchange effectively crashed straight out of the gate in 2014. And still the years add up.

Efforts to get back on track with Vermont Health Connect after its faulty rollout are consuming so much of the state’s resources that all other big health-related IT projects are on hold. That’s despite federal pressure to get them done.

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