Vermont and Minnesota Experiences

Using the MITA SS-A to Align Procurements

with Your Future State

Lorrie Scardino, Blue Tack Consulting, Moderator

Agenda

Vermont Experience:

• Michael Hall, Vermont Agency of Human Services, Associate CIO for Health Care

• Kevin Chartrand, Gartner Consulting, Director of Health and Human Services

Consulting

Minnesota Experience:

• Thomas Baden, Minnesota Department of Human Services, CIO, MN.IT Services

• Renea Steele, CSG Government Solutions, Client Executive, Practice Lead

Questions

Vermont’s MITA Journey

The Beginnings

Defining “As Is”... Then

Defining “As Is”... Now

Vermont Today

Gartner’s Engagement

MITA as Part of Major Change

Making MITA Work for Vermont

Using MITA for Procurements

Using Metrics Throughout Business and System Lifecycle

The Results So Far

Challenges in the Journey

VT Background & History

• Vermont Agency of Human Services

4

Conceptualizing SOA

A Vermont MITA Journey

In the Beginning – Discovering Commonalities

In the Beginning – Discovering MITA

2008 MITA SS-A

So What

2009 AHS Enterprise IT

Architecture Strategic Plan

December 2010 Medicaid

Enterprise Architecture Analysis

2011 MES RFP

Business Architecture for Medicaid

7

The “As Is” State Back Then

8

First attempts at using MITA 2

9

Defining the “As Is” State Today

10

Vermont Health Today o Where Vermont is in MITA 3 and MMIS procurement efforts

Combined SS-A RFP Project

o The SS-A and Strategic Plan Interrelationship

Sustainability – Vermontizing MITA

11

Vermont’s Use of MITA 3.X

12

=

Gartner’s History, Objectives, and Role

13

The Goal: Using MITA for Major

Transformation and Change

HSE Image

Business Specific

Applications

Supporting

Unique

Transactions

HHS Platform – Common Services

External

Technology

Service Providers

Saas

Key =

Setting the Stage – Mapping MITA to

Vermont’s Business Model

Leveraging Assets to Develop

Procurement Requirements

16

Business Process

Validation Workshops

Draft Functional

Requirements

CMS State Medicaid

Agency (SMA) Business

Processes and Use Cases

State of Vermont

Documentation

Gartner Research

and Project

Collateral

Final Functional

Requirements

Relevant Public Domain Information

Requirements Review

Workshops

Member Services Lead

Judy Jamieson

Provider Management Lead

Bill Clark

Operations Lead Samantha Haley

and Stephanie Beck

Financial Management Lead Carrie Hathaway

Project Manager Scott Brown

Requirements Review Team

Requirements Review Team

Requirements Review Team

Requirements Review Team

Technical Lead Michael Hall

Project Sponsor Lori Collins

Core MMIS Lead Samantha Haley

Business Analyst

Business Analytics Lead

Leann Miles

Requirements Review Team

Using Metrics Throughout the Solution

Lifecycle

17

Strategic Planning

System/Services Procurement

Operations Management

Strategic Goals

Service Level

Agreements

Measures of

Operational

Outcomes

The Result: Vermont 2017

Alignment Between Strategic Objectives and Goals

• Technical and process solutions will meet stated business needs

We will have metrics defined for progress and success,

and we will measure against them at appropriate times

• All operational metrics and SLAs will be traceable back to

strategic goals

We will holistically embody the Seven Standards and

Conditions through Service Oriented Architecture and

technical innovation

All of this will be mapped to MITA for ease of

communication with ourselves, CMS, partners and

stakeholders

18

Challenges for the Vermont Journey

We cannot risk disrupting core business

There is not much time (there is never enough time)

There is not a lot of previous work to base this all on (but

this innovation can change lives)

There are a lot of stakeholders and stakeholder groups

New stuff happens every day (change is the only

constant)

19

Using the MITA SS-A to Align Procurements with Your Future State

Presented August, 21, 2014

At the Medicaid Enterprise Systems Conference

Denver, Colorado

By Thomas Baden and Renea Steele

Agenda

21

Overview of Minnesota Department of Human Services (DHS)

Project Overview

MITA State Self-Assessment (SS-A)

Requirements Analysis

Recommended MMIS Modernization Alternative and Timeline

Implementation Advanced Planning Document

Next Steps

August 21, 2014

Minnesota

22

State of 11,842 lakes

Minnesota has 51 kinds of mosquitoes

State Bird: Loon The bones of most birds are hollow and

light, but loons have solid bones.

The extra weight helps them dive as deep as 250 feet to search for food. They can stay underwater for up to five minutes.

Because their bodies are heavy relative to their wing size, loons need a 100- to 600-foot "runway" in order to take off from a lake.

Loons can fly more than 75 miles per hour.

The red in the loon's eye helps it to see under water.

Scientists think loons can live for 30 years or more

August 21, 2014

Strategic Alignment

23 August 21, 2014

MN.IT Services

Department of Human

Services

MN.IT @DHS

Mission

The Minnesota Department of Human Services, working

with many others, helps people meet their basic

needs so they can live in dignity and achieve their

highest potential

We focus on people, not programs

We provide ladders up and safety nets for the people we

serve.

We work in partnership with

others; we cannot do it

alone.

We are accountable for results, first to the people we

serve, and ultimately to all Minnesotans.

Serving People

24 August 21, 2014

• Individuals, Families, Government & Community organizations, Caseworkers, Health & Human Service providers, Schools, Employers, Courts and Corrections agencies

Players

• Children, Families, Adults, People with needs related to Age or Disability, Immigrant communities, At Risk Youth, and more Populations

• Food, Housing, Health Care, Stable Income, Child Care, Child Support, Crisis Management, Home-based Care, Safety & Protection, Opportunity

Needs

Continually Adapting

Respectful of Rights

and Choice

People Centered

Integrated across

Programs

Inclusive of all who

Participate

Aligned with Needs and

Capabilities

Guiding Principles

25 August 21, 2014

Integrated

• Human Services Programs

• Federal, State, Counties, Tribes

• Private & non-profits

Intelligent

• Data across programs/jurisdictions

• Across technologies

• Effectiveness measures, fraud, waste and abuse deterrence

Innovative

• Service oriented, components

• Optimized, consolidated platforms

• Continuous modernization

MMIS Context

August 21, 2014 26

Technology

• Mature foundation

• Enhancements

• Designing our future

Staff

• Silver tsunami

• Capacity

• New competencies

• Culture

Priorities

• Grand picture

• DHS priorities

• MN.IT Consolidation

• Risk profile

Project Drivers

August 21, 2014 27

Government Federal Mandate Requires MMIS

Modernization Plans State legislation Election Cycles

Technology

Disruptive technologies Cloud Mobile Pervasive information access

Financial

FFP levers Budget priorities State budget cycles

Competition

Priorities Risk aversion Appetite for change

Government

Information Technology

Financial

Competition

About CSG Government Solutions

Government Operations Consulting

National, specialized HHS, Project Assurance Services, and Unemployment Insurance Practices

Expertise

Innovation

Results Strategy & Planning

• Enterprise IT Strategy

• Planning & Requirements

• Enterprise Technical Architecture

• Procurement Support

Project Assurance

• Project Management / PMO

• Independent Verification & Validation (IV&V)

• Quality Assurance

• User Acceptance Testing

Technology Design and Implementation

• Technical System Design

• Business Process Design

• Software Development and Testing

• Deployment and Training

Healthcare and Human Services Thought Leadership • Project Assurance Services tailored to HHS priorities

• Established Centers of Excellence

• Industry participation and partnership

• CSG REALize℠ Maturity Models and Best Practices

28 August 21, 2014

Project Scope

August 21, 2014 29

Timeline

August 21, 2014 30

Comprehensive Project Management Plan Submitted 10/25/2014

As-Is MMIS Assessment Document 10/30/2014 MITA Workshops 11/21/2014 to February 11, 2014 Requirements Analysis completed 4/02/2014 Feasibility Study and Alternatives Assessment Documents

completed 4/03/2014 Buy/Build Decision made April 2014 MITA 3.0 State Self-Assessment package complete 4/30/2014 Draft IAPD submitted 5/7/2014 Project Closed 5/27/14

20142013

Feb Mar Apr May Jun JulSep Oct Nov Dec Jan

PROJECT TIMELINE

10/1/13Project Start

10/15/13Project Kick-Off

10/24/13Executive

Visioning Session

11/18/13MITA Training

Complete

2/11/14BA, IA, TA, and 7C&S Workshops Complete

4/24/14Buy / Build

Recommendation

5/7/14Draft IAPD Complete

5/27/14Project Closing

3/27/14Recommendation for

SOA Governance

SS-A Key Activities

August 21, 2014 31

Seven month duration

Visioning Session with Key Executives

12 MITA Training Sessions

50 MITA Workshops

260 DHS Subject Matter Experts (SMEs) participated

Develop Training Materials and

Facilitate MITA SS-A Training

Perform MITA Current State As-Is Analysis

Conduct Visioning Workshops & Develop

Initial Concept of Operations and MITA

Roadmap

Conduct MITA As-Is & To-Be Workshop:

Business Architecture SS-A

Perform Gap Analysis and Finalize Concept

of Operations

Conduct MITA As-Is & To-Be Workshop:

Information & Technical

Architecture SS-As

Finalize MITA Roadmap and

Strategic Planning Document

MITA State Self-Assessment

Conduct MITA As-Is & To-Be Workshop:

Seven Conditions and Standards SS-A

TeamCSG℠ MITA 3.0 SS-A Tracer Tool

Features and Benefits:

Powerful collaboration tool accessible via the Internet and deployed on Microsoft SharePoint

Captures and centrally stores all MITA SS-A project data

Full-featured reporting capabilities with flexible export capability and support of multiple formats

Ease of use and data consistency

Relational database platform

32 August 21, 2014

TeamCSG℠ MITA 3.0 SS-A Tracer Tool

August 21, 2014 33

MITA tool screenshot

High Level Requirements

August 21, 2014 34

Over 700 high level requirements for advancement were recommended by SMES

Represents gaps between the current MMIS functionality and the To-Be functionality

The high level requirements were analyzed and grouped into 17 activities needed to achieve maturity and alignment with MITA and DHS goals and objectives

Included as part of the Implementation Advanced Planning Document (IAPD)

Recommended MMIS Modernization Where We Are (As-Is)

August 21, 2014 35

CURRENT MMIS: WHERE WE ARE

A Proven, Excellent System:

History of Clean Payments

Has Prevented and Avoided Fraud and Abuse

Strong System Uptime and Performance

Favorable Cost Metrics: Claims Paid Within Federal Mandates

In Fiscal Year 2012, MMIS processed:

38 Million Fee-For-Service Claims

40 Million Encounter Claims

8 Million Capitation Premiums to Managed Care Providers

Pros

Aged, Unsustainable Technology

Silver Tsunami

Federal Mandates

Inflexible Platform

Cons

Recommended MMIS Modernization Where We Are Going (To-Be)

August 21, 2014 36

MMIS MODERNIZATION: WHERE WE ARE GOING

Leverages

the Value

Locked Up in

Mainframe

Leverages

COTS

Intelligently

Meets Federal

Mandates

and Objectives

(MITA Seven

Conditions

and Standards)

MN MMISModernization

Creates a Modern

Intelligent Platform

Supporting Integration

and Innovation

A selective COBOL conversion of the core MMIS, but one that allows for full mainframe replacement, plus additional distributed platform functionality

Replacement of several subsystems with COTS on a distributed platform

Enhanced/Commercial-Off-The-Shelf

(COTS) Hybrid

Next Steps

Build On IT

August 21, 2014 38

Continue the momentum garnered during the project through the

continued engagement of the SMEs and other key

stakeholders

MITA SS-A foundation for

MMIS Modernization

MITA SS-A is a working

document

Moving Forward

August 21, 2014 39

Integrated Intelligent Innovative

Questions