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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