1. September 26, 2003
Replacing Silos with Technology: Sharing Data Across Medicaid and Education

2. Contact Information
Roberta Puffer
Steve Koruna
Please feel free to contact us with any questions you may have about the following presentation, or for further information regarding our solutions and services for school based Medicaid reimbursement

3. Agenda Challenges facing Education and Medicaid agencies
An approach for data sharing across organizations
Data and sharing strategies and benefits
Data sharing success stories
Conclusions
Questions

4. Challenges Facing Medicaid and Education Agencies

5. Program and policy challenges
Implementations are unique from state to state
State flexibility
CMS regional oversight
Schools and states are challenged to keep pace with complex and changing regulations:
CMS Guidelines and ongoing program changes
Multiple interpretations of Federal policy
Schools need ready access to considerable subject matter expertise to participate effectively
Staffing and funding shortfalls at both agencies exist; there are insufficient funds to pay for necessary program administration
Coordination challenges with related programs, such as No Child Left Behind and proposed IDEA reauthorization

6. Interagency coordination and communication challenges
Where Education and Medicaid both play an active role, challenges surrounding coordination of roles can emerge:
Conflicting priorities
Communication protocols
Specialized expertise
When the program is lead by only one of the agencies - Medicaid or Education - , communication challenges may occur
LEAs are not a natural constituent of CMS or Medicaid
The sheer volume and complexity of program information to be communicated and maintained leads to a host of training issues at all levels
CMS
State Medicaid
Agency
State Education
Agency
Local Education Agency

7. Data collection and management challenges
Direct Service Reimbursement
Documentation
Data
Uses
DS or MAC Participation
Student
Information
Special
Ed. Status
Financial
Data
Common
Data
Requirements
Medicaid
Eligibility
Staff
Credentials
Service
Documentation.
Transportation
Data
Administrative Management
Systems
Student Information System
Financial
System
Special Ed. Solution or Documentation
State Medicaid System (s)
State Education System (s)
Data
Sources

8. Data collection and management challenges
Special
Education
Documentation
Data
Uses
Student
Information
Special
Ed. Status
Common
Data
Requirements
Staff
Credentials
Service
Documentation.
Transportation
Data
State Medicaid System (s)
State Medicaid System (s)
Administrative Management
Systems
Financial
System
State Medicaid System (s)
Data
Sources
Student Information System
Special Ed. Solution or Documentation
State Education System (s)
State Education System (s)
State Education System (s)

9. Data collection and management challenges
Direct Service Reimbursement
Documentation
Special
Education
Documentation
Data
Uses
DS or MAC Participation
Student
Information
Special
Ed. Status
Financial
Data
Common
Data
Requirements
Medicaid
Eligibility
Staff
Credentials
Service
Documentation.
Transportation
Data
State Medicaid System (s)
State Medicaid System (s)
Administrative Management
Systems
Financial
System
State Medicaid System (s)
Data
Sources
Student Information System
Special Ed. Solution or Documentation
State Education System (s)
State Education System (s)
State Education System (s)

10. Data collection and management challenges
MAC
Documentation
Direct Service Reimbursement
Documentation
Special
Education
Documentation
State/Federal
Reporting
Data
Uses
Activities performed
DS or MAC Participation
Student
Information
Special
Ed. Status
Financial
Data
Common
Data
Requirements
Medicaid
Eligibility
Staff
Credentials
Service
Documentation.
Transportation
Data
State Medicaid System (s)
State Medicaid System (s)
Administrative Management
Systems
Financial
System
State Medicaid System (s)
Data
Sources
Student Information System
Special Ed. Solution or Documentation
State Education System (s)
State Education System (s)
State Education System (s)

11. Data challenges created by silos
Efficiency
Data is collected to support programs, rather than as part of natural processes.
Technology involved is also typically program specific. As a result:
Schools are incurring costs for multiple technology solutions, MAC and DS vendors, and internal costs to develop state reporting.
States incur additional costs to process claims and manage state reporting.
A primary benefit of technology is not realized due to lack of integration.
Effectiveness
Data is not as accurate as it could be, as it is not collected at the source.
Inability to effectively reconcile information across programs:
MAC and DS
DS and Special Education
Management
Inability to manage and monitor programs on a proactive basis.
Data does not become information until the claim is filed, yet the building blocks to prevent errors existed long before.
Inability to measure program outcomes effectively