The Nevada Division of Health Care Financing and Policy has signed a five-year, $176 million agreement with HP Enterprise Services to strengthen Medicaid operations and help position the state for healthcare reform.
Under the new contract, HP will become Nevada's Medicaid fiscal agent and will help upgrade and manage the Silver State's Medicaid Management Information System. HP also will help the agency enhance service delivery to Medicaid clients and improve staff productivity. The agency is responsible for Medicaid benefits for almost 300,000 Nevada residents and processes about 12 million Medicaid claims per year.
[See also: CMS offers states guidance for Medicaid health IT projects.]
"We look to HP for a smooth transition to more effectively administer benefits to our residents and provide excellent policy guidance to help us prepare for and manage challenges such as healthcare reform," said Charles Duarte, Medicaid Administrator for Nevada. "We selected HP based on its deep knowledge and experience to help us enhance our Medicaid program operations to benefit Nevada's Medicaid clients, healthcare providers and other stakeholders."
HP administers $95 billion in benefits a year and serves as fiscal agent or principal IT provider to 21 other Medicaid programs. As the nation's largest provider of Medicaid and Medicare process management services, HP executives say its technology and experience will help deliver a smooth system takeover and transition for Nevada providers.
Under the agreement, HP will process medical and pharmacy claims as well as review and process prior authorization requests in addition to utilization management and personal care reviews for the state. HP also will assist the Medicaid program in connecting healthcare providers with critical health information to improve overall care.
[See also: CMS awards $200M IT contract to HP.]
HP will also aid the state in detecting potential fraud and abuse cases while improving the efficiency of claims processing. It will add new decision-support systems and services, enabling better decision making through more accurate and up-to-date information.
All of these steps are designed to lower the risks, costs and challenges associated with the state's Medicaid program, officials say.
"All states are preparing for demands required by new healthcare reform legislation," said Susan Arthur, vice president, U.S. Healthcare Industry, HP Enterprise Services. "HP will build on our deep industry, applications and infrastructure expertise as well as experience from supporting 21 other states' Medicaid programs to ensure Nevada can deliver quality healthcare to Medicaid clients while continuing to remain responsible stewards of state revenues."