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 in the Procurement/ Implementation Life-Cycle

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.

Current Medicaid Enterprise Management Environment (MEME)

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