Chapter 2 - MITA 3.0 State Self-Assessment

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Primary Guidelines SS-A Companion Guide
Primary Methodology State- or Vendor-specific Methodology
Input NASCIO EA Toolkit, State CIO EA, Medicaid Enterprise Architecture Framework
Primary Activities BPM Mapping, BCM Assessments, Seven Conditions Assessments, Supporting Evidence Database Creation and Population
Output As-Is and To-Be Values with Supporting Evidence, Gap Analysis, MITA Maturity Roadmap, MECT Checklists
Downstream Activities Supported Medicaid Enterprise Certification Roadmap

Introduction

The body of MITA 3.0 documentation, published by CMS in February 2012, provides a comprehensive treatment of the SS-A process. ReadyCert was designed to exactly track with the SS-A processes described in the SS-A Companion Guide and the MITA 3.0 documentation. ReadyCert is pre-loaded with all MITA elements and values. ReadyCert helps ensure the correct linkage of information, maximizes reuse of the information and assures compliance with the MITA framework.

MITA begins with business processes. While the majority of Medicaid business processes reside in the State Medicaid Agency, the SS-A requires integration with other state departments and agencies. The integration is required to understand end-to-end business processes and to gather supporting evidence for the As-Is and To-Be states. The overall Project Management methodology will drive the process for engaging with and obtaining information from other departments and agencies within the state.

If the state has a MITA SS-A performed using MITA 2.1, it may be beneficial to load the values from that assessment into ReadyCert. This will give the team a starting point from which to perform the MITA 3.0 SS-A. SS-As performed using MITA 2.0 are generally not transferable to MITA 3.0 due to the substantial change in framework from version 2.0 to 3.0.

Map Current Business Processes

ReadyCert is pre-loaded with all the business processes included in the MITA BPM. Using the MITA BPM, map all business processes used by the SMA and other approved agencies and departments to the MITA framework.

For SMA business processes that do not have an associated process in the MITA framework, look across the MITA BPM to determine if there is, in fact, a match between the SMA’s process and the MITA BPM. If an associated business process cannot be found in the MITA BPM, it is identified as a State-specific business process.

It is recommended that State-specific business processes be resolved as comprehensively as possible at this stage. Engage in facilitated sessions with SMA staff and business process owners to determine if any of the State-specific processes can be consolidated, eliminated or otherwise adjudicated in accordance with the MITA framework.

The resulting map forms the SMA BPM, which is aligned to the MITA BPM. This mapping is used in the SS-A and creates the MECT checklists that are used throughout the CMS certification process.

Create Supporting Evidence Catalog

Organize material, a baseline of which can be found in the SS-A Companion Guide. Supplement the material with any state-specific documentation that will substantiate the As-Is and To-Be assessment in subsequent steps.to create a Supporting Evidence Catalog in the SMA’s central documentation repository. CMS-suggested supporting evidence is identified in the SS-A Companion Guide. The SMA identifies all state-specific supporting evidence. The material included in this catalog is used as supporting evidence for the assessed maturity level for As-Is, To-Be states across the Business, Information and Technical Architectures and the Seven Conditions.

The organization’s central document repository should hold the official version of the documentation. The process of attaching the supporting evidence should be from the repository to ReadyCert. It is not recommended that a local copy of supporting evidence be maintained in ReadyCert as version control issues may ensue.

ReadyCert is compatible with SharePoint. When a document that has been used as supporting evidence is updated in SharePoint, an alert is sent to the MITA PMO via ReadyCert. The PMO may then decide if the supporting evidence should be updated in ReadyCert.

Assess and Prove the As-Is and To-Be States

The MITA BCM defines the level of maturity associated with current and future state capabilities of each business process. The As-Is and To-Be levels are one through five. Each business process is evaluated against three architectural layers to include Business, Information, and Technical, and against the Seven Conditions.

The ReadyCert tool is pre-loaded with the BCM values and descriptions. Each business process has an associated Business, Information and Technical Architecture screen. ReadyCert contains the BCM values for each business process, or, in other words, the capabilities that represent maturity levels 1, 2, 3, 4 and 5.

It is recommended that As-Is and To-Be states be assessed in tandem, rather than performing all of the As-Is assessments and then going back and performing the To-Be assessments.

Examine the As-Is capability descriptions, determine the appropriate value and enter it. Attach the appropriate evidence used to support the assessed value. Examine the To-Be capability descriptions, determine the appropriate value and enter it. Attach the appropriate evidence used to support the assessed value.

If additional supporting evidence is required, follow administrative and management protocols for adding the evidence to the Supporting Evidence Database before attaching it to the assessed values.

It is recommended that a small core team makes the initial assessment of the level of maturity for the As-Is and To-Be states. This approach facilitates objective, fact-based assessments made based on standards interpreted and enforced by the small core team. It provides a starting point from which to review the As-Is and To-Be maturity levels. If the process owner or other designated staff disagrees with the initial assessment, it is simply a matter of updating the maturity value. This approach puts the As-Is values in a “review and approve” mode, rather than a “starting from scratch” mode, which improves efficiency and resource utilization.

Once the level of maturity is defined for each business process against the BCM, assess the business process against the Seven Conditions. ReadyCert is pre-populated with the attributes for each of the Seven Conditions, for each Business Process. Examine the Seven Conditions descriptions, determine the appropriate value and enter it. Attach the appropriate evidence used to support the assessed value.

Create Scorecards

ReadyCert automatically produces scorecards that show the As-Is and To-Be states for each business process for each of the three architectural layers and the Seven Conditions. The scorecards are used in several downstream activities, including creation of the MITA Maturity Road Map and its components, such as the Strategic Plan, APDs, resulting RFPs, IT solution deployment and CMS Certification.

The SS-A scorecards are not mandated by CMS but are suggested. In as much as ReadyCert automatically produces the scorecards, it is recommended that they be produced and used in downstream activities. Each scorecard has a specific purpose, as summarized below.

  • Business Architecture Scorecard- This summarizes the State Medicaid Enterprise’s As-Is and To-Be capabilities.
  • Information Architecture Scorecard- This summarizes the As-Is and To-Be conditions based on the standards of Data Management Strategy (DMS), Conceptual Data Model (CDM), Logical Data Model (LDM), and Data Standards.
  • Technical Architecture Scorecard- This summarizes the As-Is and To-Be conditions based on the Technical Service Areas and Technical Service Classifications.
  • Seven Standards and Conditions Scorecard- This provides an evaluation tool and guide for assessing the current and future capabilities of the Medicaid Enterprise against CMS’ Seven Conditions and Standards for Enhanced Federal Funding.

Develop the Gap Analysis

The Gap Analysis describes the delta between the As-Is and To-Be states and supports the state’s transition planning to attain the future state. The Gap Analysis is prepared for all of the processes in the BPM, evaluating the As-Is and To-Be maturity levels, using the criteria in the BCM, for each of three architectures, (Business, Information and Technology), and for the Seven Conditions. The Gap Analysis informs the MITA Maturity Road Map and APD.

It is recommended that the initial Gap Analysis be performed at an individual business process level and then rolled-up to a Business Objective level. This allows SMA executive leadership and decision makers to view gaps more broadly, while allowing those responsible for filling in the gaps to view them more narrowly. It also provides linkage from the Gap Analysis to downstream MECT checklists, used extensively throughout the CMS certification process.

Identify Executive Management Priorities and the Relation of these to the Gaps

Prioritize the plans for filling the gaps. The gaps that are the highest priority to close are identified and given highest weight in transition planning. The gaps that are a medium or low priority are given appropriate weight. Where a medium or low priority gap can be consolidated with a higher priority one, a crosswalk from the lower priority gap is made, with rationale for assigning it to the higher priority gap.

Describe Recommended Actions to Close the Gaps

Research options that are MITA-aligned, adhere to industry standards, and have risks that can be managed. Consider the effect of other SMA initiatives that may affect plans to close gaps identified in the SS-A. Document the recommended approach for closing the gaps, the rationale for the recommendation, alternatives considered, and the rationale for dismissing them.

Assess Effect of Recommended Actions on Governance and Organization

As the recommended actions are developed, assess the effects of these actions on the current SMA IT governance model and organization structure. If the IT Governance model or organization requires modification, document the recommended changes and rationale for them. Document the recommendations, with the rationale, and include the recommendations in the Gap Analysis.

Prepare the Gap Analysis Report

The Gap Analysis Report includes outcomes from all preceding work activities. The Gap Analysis is used to inform the MITA Maturity Road Map and becomes part of it.

Develop the MITA Maturity Road Map

Use the As-Is and To-Be assessments to create the MITA Maturity Roadmap. Using the state’s vision, goals and objectives, establish priorities and timelines for increasing the maturity levels for Business Process Areas and Business Objectives from the MITA BPM. ReadyCert automatically produces MITA Maturity Roadmaps graphical depictions for Business Process Areas and Business Objectives.

The graphic depiction is supplemented with textual documentation, as per the SS-A Companion Guide. The MITA Maturity Road Map includes the following chapters, which are developed in accordance with the overall project management methodology:

  • Statement of Goals and Objectives
  • Project Management Plan
  • Proposed Project Budget

In its final form, the MITA Maturity Roadmap has the graphic depiction produced by the ReadyCert tool and textual sections, as noted above and supplemented with state-specific sections, if any.

The MITA Maturity Roadmap is built to provide a framework for the SMA to transition to the future, To-Be state. It describes both near- and long-term activities. The ultimate timing of each recommendation may vary depending upon key decisions, prioritization and funding. In addition, the intent of this Road Map is to provide a starting point for the work breakdown structure for all change activities.

Identify Internal and External Sources to Support Achievement of Higher Levels of MITA Maturity

The MITA framework and initiative guide encourages States’ to replace legacy MMIS technology in favor of SOA-based solutions. As such, the process of identifying technology components has become more important in the context of the SS-A. The delta between the As-Is and To-Be for a discrete Business Process area may be closed by replacing part of the legacy MMIS with a commercial solution. The commercial solution may have several deployment options, such as installing the solution in DHCF's environment or accessing it via the cloud solution. The days of examining single solutions, capable of performing a myriad of functions, have been replaced in favor of evaluating discrete solutions that can operate as part of a larger, SOA-based, enterprise-wide platform.

The MITA Maturity Road Map lays the foundation for defining the transition plan for each of the three architectural layers. The Gap Analysis, which informs the MITA Maturity Road Map, identifies the delta between the As-Is and To-Be state for the BPM assessed against the BCM and Seven Conditions. As part of the process of examining alternatives to close the gaps, the project team identifies the sources and resulting plans and procurements that can be used to close the gaps.

When a recommended action is determined, examine the assessed value and supporting evidence in ReadyCert. If the plan to close the gap results in a change to the assessed To-Be value, enter the new value. If new supporting evidence, generally in the form of internal or external sourcing planning documents, has to be added, attach it to the applicable business processes for any of the three architectural layers or Seven Conditions affected. All new supporting evidence needs to be stored in the Supporting Evidence Catalog.

Finalize SS-A Output

After the initial assessments, Gap Analysis and MITA Maturity Roadmaps are reviewed and updated with priorities, recommendations and plans, finalize the SS-A output. ReadyCert automatically produces the final As-Is and To-Be assessments, the graphical depiction of the Gap Analysis and the MITA Maturity Roadmap and the MECT checklists.

Notes