DHHS briefed Division III on IT systems, contracting processes and Medicaid enterprise modernization

Officials from the New Hampshire Department of Health and Human Services briefed House Finance Division III on Jan. 28 on information systems, centralized contracting, the department’s portfolio management office and quality-and-integrity functions as the agency prepares for the governor’s budget.

Nathan White, chief financial officer at DHHS, said the department relies on roughly 130 distinct systems and is pursuing enterprise approaches for constituent management, data warehousing, learning-management and closed-loop referrals. “Right now we actually have about 130 different systems,” White said, describing a portfolio that includes Salesforce, an enterprise business-intelligence platform, New Hampshire Care Connections (a closed-loop referral network), New Heights (the integrated eligibility and enrollment system) and the Medicaid enterprise systems used for claims and provider management.

DHHS officials described the Portfolio Management Office and a push to standardize project intake and governance. David Wieters, chief operating officer, said the PMO has trained more than 280 staff in standardized project methods and reported completing 106 projects during the last year with about 104 open now; the PMO is intended to reduce duplicative work and surface project health across the department.

Officials also outlined contracting volumes and reforms. The department’s central contracting bureau processes a high volume of solicitations and contracts, the presenters said, with roughly $2 billion in contracts and amendments managed annually (including managed-care organization contracts). The contracts team has increased solicitation notice periods and deployed DocuSign to speed signature turnaround; DHHS said a previously multiweek signature process has in some cases been reduced to under an hour when prework is complete.

The department provided details on the Medicaid enterprise system (MES) modernization effort and related capital needs. White said the current Medicaid claims system dates to the mid-2000s, has known pain points (for example, provider enrollment and call-center management), and is midway through a 10-year replacement plan. He said a capital submittal in the public-works process includes a $33,750,000 request tied to third-party liability, call-center improvements and member management; White said capital projects produce both a one-time cost and recurring maintenance and operations expenses the agency will include in future operating budgets.

Committee members asked for an IT-focused briefing that emphasizes system stability, end-of-life concerns, key interfaces and operational impacts. The chair requested a return presentation that profiles each major system with answers to: Is the platform stable? What end-of-life or upgrade needs exist? Which interfaces are brittle or need a standards-based interface engine? White and Wieters acknowledged some legacy components remain on-premise (for example, Nexus and New Heights) and said the agency plans to procure a system integrator and move toward standard APIs to reduce point-to-point interface costs.

Officials discussed specific platforms and implementations:

- New Heights (integrated eligibility/enrollment) and New Hampshire Easy (public portal) manage applications for SNAP, TANF and Medicaid; DHHS said it is pursuing usability and workforce efficiency improvements for the New Heights call-center users. - New Hampshire Care Connections is intended to enable consent-based closed-loop referrals among health and human service providers; DHHS said provider onboarding will begin in the coming months and that some providers may already participate via vendor-hosted networks. - Everlaw, an e-discovery platform, was described as a tool to accelerate legal reviews, but White said capacity (storage) and licensing would limit how many concurrent large-scale records requests the department could process without further funding.

On contracting and program oversight, Meredith Toulouse, director of Program Quality and Integrity, described tools DHHS uses to manage provider risk, detect fraud or improper billing, and enforce contract requirements. Toulouse said DPQI facilitates federal audits, performs risk-based financial reviews of selected provider types (for example, area agencies, community mental-health centers and substance-use treatment providers), and coordinates corrective-action plans when financial or operational risks appear. She said the department has referred suspicious cases to the state Medicaid Fraud Control Unit and pursues recoveries and other remedies where appropriate.

DHHS officials said they are pursuing several process improvements: implementing a lifecycle contract-management policy, publishing active-contract-management tools for program managers, piloting risk-based invoicing to reduce provider administrative burden, and exploring CloudSuite (a statewide administrative platform) as a future enterprise contract-management and finance solution. Officials also flagged organizational constraints: some on-premise systems require hardware lifecycle replacement and a multi-year capital plan; vendor interfaces remain a major source of maintenance cost; and the state’s procurement and effective-date timelines can require manual workarounds when accelerated implementation is needed.

Committee members asked for follow-up materials, including a system-by-system profile (stability, end-of-life, interfaces, required upgrades and expected operational cost impacts), a list of systems scheduled for decommissioning, and more detailed information about closed-loop referral onboarding and privacy safeguards.