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The Medicaid Assessment Planning Project (MAPP) is designed to improve Utah's Medicaid operations. Key figures involved include Paula McGuire, Mike Webb, John Strong, and others. The project includes 12 phases such as the State Self-Assessment, Gap Analysis, Cost Benefit Analysis, and development of Requests for Information and Proposals. MAPP aims to evaluate the current Medicaid Enterprise's business and technical architectures and determine a strategic plan for the next 5-10 years. Key decisions involve the optimal management of Medicaid Management Information Systems (MMIS), considering options from state-operated integrations to contractor-facilitated management.
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Medicaid Assessment Planning Project (MAPP) Paula McGuire, Product/Project Manager Bureau Director for Medicaid Operations Mike Webb – Technical Project Manager John Strong – Business Project Manager Michael Deily – Business Consultant Dennis Tingey – Technical Consultant Steve Nelson – FOX Project Manager Division of Health Care Finance Utah Department of Health Oct. 28, 2009
Outline • What and who is MAPP • Project Summary • What have we been doing • Current status • Issues and Concerns • Time line • Budget
Project consists of 12 deliverables • Phase 1 – State Self Assessment (SS-A) • Phase 2 – Gap Analysis • Phase 3 – Assessment of State Administrative Capabilities • Phase 4 – Cost Benefit Analysis • Phase 5 – Request for Information (RFI) • Phase 6 – Research, Analyze & Describe Proven practices • Phase 7 – Model System Architecture • Phase 8 – Regional CMS Face-to-Face meeting • Phase 9 – Requirements Analysis & Documentation • Phase 10 – Write Design, Develop, Implement (DDI), • Advanced Planning Document (APD) • Phase 11 – Write DDI Request for Proposal (RFP) and Procure vendor • Phase 12 – Write IV&V RFP and Procure Vendor
MITA State Self Assessment and MITA Maturity • Mapping of Utah Business Processes to MITA • Capturing the AS-IS picture of the Utah Medicaid Enterprise Business • Capturing the AS-IS picture of the Utah Medicaid Enterprise Technical Architecture • Assessing these Architectures against the MITA Maturity Model (Five levels) • level 1 - processes are primarily manual • Level 2 - mixture of manual and automation, standards introduced • Level 3 - Processes are primarily automated • Level 4 - Widespread and secure access to clinical data. Focus on program improvement • Level 5 - National and international interoperability • Determining the strategic To- Be picture of the Utah Medicaid Enterprise Business and Technical Architectures for the next 5 – 10 years.
Options evaluated, that should not be considered because of excessive risk or cost. • Do nothing and continue with the existing MMIS • Re-engineer the current MMIS • Build a new MMIS from the ground up
Utah has identified four major options for a continued certified MMIS support for its Medicaid program • All Options: Utah chooses a state-of-the-art, certifiable MMIS to transfer, modify, and enhance • Option A (State Integrator): Using State staff augmented by contractor support.The risk & responsibility of successful completion on the State • Option B (Contractor Integrator): Contractor under the management of the State. May include a one-year option for the contractor to maintain and operate the MMIS. The risk and responsibility for successful completion on the contractor.
Options continued • Option C (Facility Management (FM)): After implementation, the Contactor continues to function as an FM to maintain and operates the MMIS • Option D (Fiscal Agent (FA)): Fiscal Agent Contractor continues to function as an FA to maintain, and operate MMIS and support designated Medicaid business processes.
Issues and Concerns Time line Budget Resources
