States generally develop their own Medicaid Management Information Systems (MMIS), which make up the information technology backbone for coordinating care among enrollees, providers and others in the health-care ecosystem. Many states are involved in some level of technology updates or new policy considerations related to Medicaid with the goals of improving service delivery, beefing up cybersecurity protections or preventing fraud. But complicating these efforts is how proposed changes to both Medicaid and the Affordable Care Act will impact coverage, eligibility and funding. In July, the U.S. Senate passed the One Big Beautiful Bill Act, which will make significant changes to these programs. The Congressional Budget Office estimates 12 million residents will lose health coverage by 2034 under the bill.
WYOMING
WINGS serves about 100,000 residents and is “a stable, modern system available with changes and upgrades occurring much quicker than previously. This has allowed more flexibility in responding to new federal and state directives,” said Jesse Springer, deputy division administrator in the Division of Healthcare Financing at the Wyoming Department of Health, in an email outlining some of the improvements WINGS has compared to its predecessor.
WINGS is composed of 10 “Medicaid modules,” Springer explained. Each has its own procurement process, with one to two modules completed per year. So far, nine modules have been completed, and three are active: pharmacy; fraud, waste and abuse; and care case management.
Modules are operated independently by their respective vendor partners, but the evoBrix platform allows them to be interoperable.
“Each module is fully independent, on separate cloud hosting and environments, and fully operated by the responsible vendor providing that module,” Springer said. “If a single module is not operating for any reason, all other modules continue to operate relatively unaffected.”
The Pharmacy Benefit Management System went live in 2017 and was a partnership with Change Healthcare, according to the state’s Department of Health website. However, it is undergoing a “major upgrade,” in partnership with OptumRx (formerly Change Healthcare), and is expected to be deployed in December 2025.
The fraud, waste and abuse system 2.0, a joint effort with Deloitte Transactions and Business Analytics, is an update of the previous fraud system and went live in June 2025. The Benefit Management System went live in 2021, in partnership with Client Network Services.
The care case management module is a partnership with Cardinality, replacing a custom state-owned system. It is projected to go live in August 2026, Springer said, at which point “the oldest MMIS component module in Wyoming will have been installed in 2019.”
In addition to improved service delivery, the new Medicaid management system provides improved cybersecurity protections for the state and its residents. All modules are hosted on services that carry the FedRAMP moderate-level certification, and the state regularly does security testing.
WASHINGTON
Washington state has also been involved in improvements to its Medicaid delivery and management system, as part of the state’s commitment to “whole person care.”
A significant component of Washington’s Medicaid Transformation Project (MTP) 2.0 is the Community Information Exchange (CIE) program, a technology initiative to help communities better coordinate services across a network of care providers in government, nonprofit, tribal or other organizations.
The program will standardize data to make it more easily shared; smooth the interoperability among local, state and regional technology systems; and scale the work of regional “Community Care hubs,” which work closely with community organizations to connect residents with health care and social services.
Katie Pope, deputy chief communications officer for the Washington Health Care Authority (HCA), which oversees the state Medicaid program, called Apple Health, said via email that they are “currently in an active procurement process for a lead organization for the CIE” but offered no other details.
The RFP for the $91.2 million project closed July 16, with work expected to begin in September.
“Modernization is an ongoing process and there is no set completion date,” Pope said. “We regularly assess and implement changes to enhance functionality, improve user experience, and ensure compliance with state and federal requirements.”
The CIE project is intended to make it easier to coordinate among providers, who, in addition to health-care workers, include other forms of assistance like food programs or transportation, which can impact health in ways large and small.
Pope said the project is part of HCA’s “iterative approach to modernizing and improving our Medicaid Management Information System” that gets health-care coverage to more than 2 million residents.
This story originally appeared in the Summer 2025 issue of Government Technology. Click here to view the full digital edition online.
