Medicaid Assessment Planning Project (MAPP)

1. 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

2. Outline • What and who is MAPP • Project Summary • What have we been doing • Current status • Issues and Concerns • Time line • Budget

3. 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

4. MITA in the Procurement/Implementation Life-Cycle

5. 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.

6. Current Medicaid Enterprise Management Environment (MEME)

7. 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

8. 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.

9. 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.

10. Issues and Concerns Time line Budget Resources