customer success story state of michigan : magi case study
DESCRIPTION
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 - PowerPoint PPT PresentationTRANSCRIPT
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Customer Success StoryState of Michigan : MAGI Case Study
Beth Long, CGIDon Kosy, Oracle Consulting
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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
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MAGI Vendor SelectionWhy 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
oEnglish language rules engineoSelf-explaining decisions
• CGI Façade maps the Federal AT schema data to OPA• CGI + OPA Team Experience / Skills• Bid Competitiveness to Overall Value
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MAGI Eligibility Service Architecture
FFM MMIS
Rules Repository
(Version Control File
Share)
SOM HUBSOM Zone 3
Data Warehouse
MAGIApplication
Server
Business AnalystsRules Admin
Rulebase DeploymentProcess
(SFTP to Cloud)
Transient CDS
Medicaid
CHIP
Federal Hub Correspondence
CGI Service Facade
VPN Circuit
VPN Circuit
Federal AT Schema
Packet
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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
MAGI Success Factors
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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
MAGI Success Factors
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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
MAGI Success FactorsCGI – Oracle Collaboration
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• 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
MAGI Success Factors
Oracle Consulting’s Role
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MAGI Success Factors
Pre-built MAGI Eligibility Rulebase
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MAGI Success FactorsGap-based Design
Requirements
Rule Design
Requirements Traceability Matrix
Requirements Scope of Work
Plan
GAP
Assessment Construct
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MAGI Success FactorsRTM - Driven
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• 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
MAGI Success FactorsOracle Policy Automation Platform
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MAGI Success Factors
Iterative Parallel Development Process
Requirements
Design
Configuration
Regression Test
Integration
Design Design
Requirements Requirements
Configuration Configuration
Regression Test
Regression Test
Integration Integration Integration
Week 0 Week 1 Week 5
Don
Ed
Rafa
Mike
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MAGI Success Factors
PM Level Support
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Embedded Requirement References
MAGI Success Factors
OCS Best Practices
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MAGI Success Factors
Decision Reports
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MAGI Challenges & Solutions
Meeting the Project Deadlines
Challenge Solution
Delivery deadline during bid less than 6 months away
Leverage a pre-built rulebase of Federal MAGI regulations
Very short ramp-up after bid awarded – first integration test in 6th week
Parallel development of Façade completely separate from Rulebase
Planned for 6 months, compressed to 4
Use an iterative parallel rule development process
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MAGI Challenges & Solutions
Tracking & Tracing Complex Requirements
Challenge Solution
Traceability of results to requirements Embedded requirement references
Traceability of results to causes Decision reports
Use same rules for same requirements across different programs
Pre-built rulebase eligibility framework
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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
MAGI Go-Live!
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•Lessons Learned•What worked well
Closing Comments
MI MAGI Customer Success
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FFM CHAMPS
Rules Repository
(Version Control File
Share)
SOM HUBSOM Zone 3
Data Warehouse
MAGIApplication
Server
Business AnalystsRules Admin
Rulebase DeploymentProcess
(SFTP to Cloud)
Transient CDS
Bridges
Maxstar
Federal Hub Correspondence
CGI Service Facade
VPN Circuit
VPN Circuit
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
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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
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What Worked Well
Dedicated Team(work)
Rafa Ed Anisia Don Mike
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•Lessons Learned•What worked well
Closing Comments
MI MAGI Customer Success
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Questions & Answers