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Medicaid Enterprise Management System RFP Pre-Release Vendor Conference

Medicaid Enterprise Management System RFP Pre-Release Vendor Conference 101 Cold Harbor, Frankfort, KY Thursday 01/24/2013 2:30 pm to 5 pm .

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Medicaid Enterprise Management System RFP Pre-Release Vendor Conference

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  1. Medicaid Enterprise Management System RFP Pre-Release Vendor Conference 101 Cold Harbor, Frankfort, KY Thursday 01/24/2013 2:30 pm to 5 pm NOTICE OF CONFIDENTIALITY:  This presentation is for the sole use of the intended recipient(s) and may contain confidential information. Any review, use, disclosure, duplication, or distribution not expressly requested by the recipient and granted by the sender is strictly prohibited. If you are not the intended recipient, please destroy all copies of the original message and attachment(s) and notify the sender immediately by e-mail.

  2. Kentucky Medicaid Enterprise Management System RFP Pre-release Vendor Conference Discussion Outline • Welcome to Kentucky and Introductions • Kentucky’s Strategic Vision for Healthcare Transformation • Medicaid Enterprise Management System RFP Structure and Scope • Medicaid Enterprise Management System Vendor Procurement Tentative Timeline • Medicaid Enterprise Management System Implementation Timeline • Open Questions and Feedback

  3. Kentucky’s Strategic Vision for Healthcare Transformation • Kentucky has developed a complete and achievable eHealth IT Architecture. • Kentucky has a consolidated Cabinet organization that encompasses all of the program pillars depicted in our vision. • CHFS Secretary Haynes and Governor Beshear have been engaged and aggressive in our efforts to improve healthcare in Kentucky and nationally.  • Early adoption of HIE, GOHIE, HBE, etc. • Focus on improved delivery and quality of healthcare through Managed Care and push to streamline MMIS.

  4. Kentucky’s Strategic Vision for Healthcare Transformation • QHI Components for CHFS Supported Systems: • Citizen, Worker, Partner Web Portals • SharePoint Document Management System • Corticon Business Rules Engine • BizTalk Enterprise Service Bus • IBM Infosphere Master Data Management • SAS Fraud Analytics • KEUPS Seamless Security Services • HP Exstream Fulfillment

  5. Medicaid Enterprise Management System RFP Structure and Scope • Option 1 MEMS System Replacement: • Design, development, implementation and maintenance of the new Kentucky Medicaid Enterprise Management System and Fiscal Agent. • Proposed solutions and pricing for the following “Options to Buy”: • System Hosting and Disaster Recovery services • Decision Support System • Utilization Management Services • Option 2 MEMS System Takeover: • Planning, migration and operations necessary to assume • the operation of the current MMIS and Fiscal Agent services. • Option 3 Combined MEMS System Replacement and Takeover: • Providing of all services necessary for Options 1 & 2. (Takeover and Replacement)

  6. Medicaid Enterprise Management System RFP Structure and Scope The Commonwealth requires that the future Medicaid Enterprise Management system be built using the following principles: • Seamless data exchange of information within QHI framework including as close as possible to real-time integration with Kentucky Health Benefits Exchange System. • Optimization of Managed Care Relationships and streamlined support for remaining Fee for Service processes. • SOA based solution comprised of components that integrate into the Commonwealth’s SOA framework or directly utilizes the Commonwealth’s components. • MITA based modular solutions from a single Vendor or a “best-of-breed” multi-vendor solution. • Meets CMS certification requirements as defined in the CMS MECT. • Comprehensive data management strategy that organizes all of the data and enables easy access to information. • Configurable and extendible solution to cost-effectively support Kentucky’s future expansion of programs and populations, and to meet current and future regulatory needs.

  7. Medicaid Enterprise Management System RFP Structure and Scope Not in RFP Scope: • Medicaid Waiver Management Application • Pharmacy Benefit Management

  8. Medicaid Enterprise Management System RFP Structure and Scope • The functional requirements cover the business operations of the enterprise. These requirements are grouped as follows: • Business Relationship Management • Care Management • Contractor Management • Financial Management • Member Management Lite • Operations Management • Program Management • Program Integrity Management • Provider Management

  9. MEMS Procurement Tentative Timeline May June December July April February March 03 10 31 17 24 04 06 06 29 06 18 27 27 01 08 22 25 04 11 15 11 13 20 13 20 13 18 25 Vendor Solicitation Release RFP Vendor written questions Ky written responses Vendor Conference / Vendor Questions Ky written responses Vendor Selection Proposals Due Proposals Scored Vendor Orals/Demos Final Scoring Vendor Selected

  10. Open Questions and Feedback

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