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Customer Success Story State of Michigan : MAGI Case Study

Customer Success Story State of Michigan : MAGI Case Study. Beth Long, CGI Don Kosy, Oracle Consulting. MAGI Overview. MAGI Project Goal Comply with new CMS Medicaid regulations as required by the Affordable Care Act (ACA) MAGI Challenges Short time to implement Complicated regulations

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Customer Success Story State of Michigan : MAGI Case Study

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  1. Customer Success StoryState of Michigan : MAGI Case Study Beth Long, CGI Don Kosy, Oracle Consulting

  2. MAGI Overview MAGI Project Goal • Comply with new CMS Medicaid regulations as required by the Affordable Care Act (ACA) MAGI Challenges • Short time to implement • Complicated regulations • Multiple SOM Departments: coordination and governance • Integrate with existing highly complex State systems, utilizing the CMS defined Federal Account Transfer schema • Extreme security and reliability requirements for cloud host environment

  3. MAGI Vendor Selection Why CGI / Oracle? • CGI provided a comprehensive project plan to meet the go-live milestones • Oracle provided an existing MAGI Eligibility Engine, built to model the Federal regulations • Oracle Policy Automation product • English language rules engine • Self-explaining decisions • CGI Façade maps the Federal AT schema data to OPA • CGI + OPA Team Experience / Skills • Bid Competitiveness to Overall Value

  4. MAGI Eligibility Service Architecture Federal AT Schema Packet

  5. MAGI Success Factors MAGI Execution Methodology • Fully track the CGI project plan • Iterate OPA activities, Overlap design/build/test cycles • Adaptation not Creation • Agile scope control based on program entity framework • Thorough State & Federal UAT integration prior to go-live 1/14

  6. MAGI Success Factors CGI – SOM Collaboration • Functioned as a Partner - not as a vendor • Demonstrated clear separation of responsibilities • Executive level support • Risk Management • Promoted a governance model for issue and risk management

  7. MAGI Success Factors CGI – Oracle Collaboration During bid development • Alliance history • Oracle OPA solution seen as best fit and value for SOM During execution • Partnership relationship rather than prime/sub • Oracle team OPA expertise • CGI project management and methodologies • CGI hosting solution and capabilities Clear separation of responsibilities

  8. MAGI Success Factors Oracle Consulting’s Role • MAGI eligibility engine experts • Gap-based design experts • Oracle Policy Automation product experts • Iterative parallel ruleset development • PM Level Support • OCS Policy Automation best practices

  9. MAGI Success Factors Pre-built MAGI Eligibility Rulebase

  10. MAGI Success Factors • Requirements Traceability Matrix • Requirements Scope of Work • Rule • Design • Gap-based Design Requirements Plan • GAP • Assessment Construct

  11. MAGI Success Factors • RTM - Driven

  12. MAGI Success Factors • Oracle Policy Automation Platform • Implementing rules uses the actual language of the requirements • Built-in regression tester finds bugs before SIT/UAT • Can build rulebase in parallel with Façade, call it as a web service • Decision reports = audit trail back to regulations and facts of the case

  13. MAGI Success Factors • Iterative Parallel Development Process Week 0 Week 1 Week 5 Requirements Requirements Requirements Don Ed Rafa Mike Design Design Design Configuration Configuration Configuration Regression Test Regression Test Regression Test Integration Integration Integration Integration

  14. MAGI Success Factors • PM Level Support

  15. MAGI Success Factors OCS Best Practices Embedded Requirement References

  16. MAGI Success Factors Decision Reports

  17. MAGI Challenges & Solutions • Meeting the Project Deadlines

  18. MAGI Challenges & Solutions • Tracking & Tracing Complex Requirements

  19. MAGI Go-Live! MAGI has implemented 4 quarterly releases over 2014 including implementation of: • 5 required MAGI Medicaid/Chip programs & 2 state options • Presumptive eligibility determinations for under 19 and pregnant women • State Medicaid Expansion program “Healthy Michigan Plan” • Integration with existing State of Michigan Medicaid and CHIP case management systems

  20. MI MAGI Customer Success • Lessons Learned • What worked well Closing Comments

  21. Lessons Learned You Need a DTM and an RTM • The devil is in the data • Need a "multi-lingual" data dictionary • Need a schema-based data-validator • Need a data council representing all producer and consumer stakeholders • Need a “data czar” to oversee and enforce data integrity

  22. What Worked Well Leveraging a Pre-Built Rulebase • This was the biggest win: Adaptation not Creation • Could skip the design, configuration, and regression test for 80% of the requirements in release 1 • Could understand and implement State requirements even when vague or incomplete • OPA upgrades were no problem • Baseline OCS has been extended to include Federal SNAP, TANF, and traditional Medicaid eligibility

  23. What Worked Well Dedicated Team(work) Rafa Ed Anisia Don Mike

  24. MI MAGI Customer Success • Lessons Learned • What worked well Closing Comments

  25. Questions & Answers

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