Mastering Data Management

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Registry hubs link and match all information about an individual beneficiary without the need to replace existing systems.

The Medicaid Information Technology Architecture (MITA) framework provides a roadmap for states to transform their MMIS environments. As an atlas – rather than a step-by-step set of directions – MITA is suggestive, not prescriptive. Rather, it includes core principles, models and national guidelines for states to follow as they enhance their MMIS environments.

MITA’s coordination of principles includes interoperability, data sharing and reusability. Its maturity and business process models and national guidelines provide a business-level view of what technical systems should enable at various stages of MMIS evolution.

Perhaps the most fundamental change that MITA presents to state Medicaid environments is that in the later stages of MMIS maturity, its suggested emphasis on systems moves beyond finance, accounting and claims processing. This beneficiary-centric approach is entirely focused on improving care and reducing costs while promoting national interoperability.

At all stages of MITA maturity, state Medicaid systems can benefit from taking a registry hub approach to matching and linking beneficiary and other Medicaid systems information. Built off of similar architectures to regional healthcare information organizations (RHIO), registry hubs can play an essential role in helping states adopt a secure, beneficiary-centric approach to Medicaid services delivery.

Registry hubs link and match all information about an individual beneficiary without the need to replace existing systems. Registries can, in real time, call information from all existing applications using standard application programming interfaces (APIs), creating instant but complete views of beneficiaries, their providers and other relationships in the Medicaid systems environment.

At the basic level, registry hubs can help transform the eligibility/qualification process, enhance fraud detection and reduce the cost of care through participation in healthcare information exchanges. For more advanced agencies and organizations, registry hubs can improve patient outcomes by providing linkages to electronic health records, different providers within a system and regional and national healthcare information systems.