Modernizing Medicaid Enterprise Systems (MES) is no longer a distant ambition—it is an urgent priority. At the 2025 Medicaid Enterprise Systems Conference (MESC), Gregg Dunning, Managing Director at North Highland, and Craig Golden, Enterprise Architect at the Georgia Department of Community Health, shared how states can move from early steps to full-scale modernization. Their session, Crawl, Walk, Run: Accelerating MES Modernization, focused on pragmatic ways to build momentum, reduce risk, and create lasting impact for providers and communities.
Modernization rarely happens all at once. Instead, states advance in phases. The “crawl” stage begins with small pilots that establish proofs of concept. The “walk” stage builds confidence by scaling infrastructure, developing minimum viable products (MVPs), and expanding adoption. The “run” stage is where agencies fully integrate modern systems across the enterprise.
Golden shared Georgia’s experience, outlining the realities of replacing legacy platforms with modern technology. He addressed the challenges of procurement, governance, and aligning diverse stakeholders. Dunning emphasized the importance of early value realization and people-centered strategies that engage agency teams and community partners, ensuring modernization efforts stick.
Together, they showed that modernization is as much about culture and approach as it is about technology. States need early wins to build trust, strong collaboration across agencies, and flexible approaches to procurement. Equally important is leadership commitment and workforce readiness to support change.
The impact extends beyond system upgrades. Modernization creates more reliable services for providers, reduces administrative burden, and improves access for beneficiaries. Better data and analytics also enable faster, more informed decisions across healthcare programs.
Takeaway: MES modernization calls for deliberate but decisive action. By starting small, scaling intentionally, and maintaining focus on people and outcomes, states can move from crawling to running. The story of Georgia, shared by Golden and Dunning, offered a compelling example of how modernization is possible today, and how the right approach can accelerate progress and reduce risk.
Ready to accelerate your state's Medicaid Enterprise Systems modernization efforts? Visit our HHS webpage to explore comprehensive resources and connect with our subject matter experts who specialize in healthcare transformation and Medicaid enterprise solutions.
