Medicaid Enterprise Data Governance Approach. MESConference August 21, 2012 Rashmi Menon, Deloitte Consulting LLP

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1 Medicaid Enterprise Data Governance Approach MESConference August 21, 2012 Rashmi Menon, Deloitte Consulting LLP

2 Agenda Session Objectives Common Barriers and Key Benefits to Data Governance A Framework Supporting Medicaid Data Governance Alignment with MITA The Elements of Data Governance Alignment with MITA Organization Structure Roles and Responsibilities Examples from the Field: The State of Texas, Health and Human Services Critical Success Factors Q&A 2

3 Session Objectives Summarize the benefits of establishing governance capabilities Outline governance program principles for Medicaid systems Discuss strategies to govern Medicaid systems to support data integration across programs Share experiences in delivering full-lifecycle data governance 3

4 Common Barriers and Key Benefits to Data Governance There are barriers to data governance, but many benefits as well Common barriers mentioned by states: Common benefits mentioned by states: This is my data and I can t share it We already have a data dictionary If it is not on a claim, it is not Medicaid data Our program is very different We don t have a tool to do that This will just become an auditing function Data is more reliable as it adheres to set ranges of values and correlates to its business definition Clearly defining the difference between an Encounter record and a Paid Claim record Allows identification of members and providers across programs Spend less time examining anomalies on reports and more time making decisions based on data Survey results1 related to barriers and benefits 4 1 Source: TDWI Best Practices Report, 2008

5 Deloitte s Data Governance Framework Deloitte s data governance framework assesses the maturity of the Medicaid Enterprise across six dimensions View View information information as a strategic as a strategic asset asset Data Architecture: Align to integrate data in Medicaid Enterprise Systems Data Architecture Organization: Provide appropriate resources to manage framework Policies, Principles & Standards: Guide organization on data areas for enterprise compliance Governance Metrics: Define how to measure compliance Organization Technology Data Governance Framework Driven by business value Processes & Practices Processes & Practices: Manage organization operation in enterprise Governance Metrics Technology: Build and monitor methods of governance 5 Enabled with a change management program Policies, Principles & Standards Linked to strategic initiatives

6 Data Governance Alignment with MITA Supports aligning agencies with MITA Maturity and provides for interoperability of data across Medicaid Enterprise Systems Medicaid Business Areas State Medicaid Agency Functions Business Relationship Care Contract Plan Eligibility and Enrollment Member Operations Provider Performance Finance State Self- Assessment MITA Framework Business Architecture Informa?on Architecture Technical Architecture Medicaid Data Governance Data Architecture Organization Policies, Principles & Standards Governance Metrics Data Quality 6 Processes & Practices Technology

7 Data Governance Organization Structure There are several potential structures for Medicaid data governance each with their own benefits and challenges Decentralized Federated Centralized Structure Key Elements Benefits Challenges Decisions made at local level No centralized governing body Local resources respond to issues Autonomous operation Data closely tied to program operation Inconsistent between programs Difficulty summarizing at enterprise level Decisions made at local level Advice of centralized body Decisions made by single organizational body for enterprise Consistency for enterprise vision and strategy of data Monitoring overall programs Decisions and enforcement established at local level Strong focus on policy setting Compliance established across enterprise Enterprise view of data Reliance on close coordination Enforcement is loosely tied to vision and strategy 7 Enterprise resources required May be contrary to agency culture

8 Data Governance Roles and Responsibilities Executive Sponsors Data Owners Define requirements for informa?on Monitor quality and availability of informa?on Authorize access to informa?on Reside in program Advise in implementation of policies Cooperatively determine data requirements Data Stewards Advise in implementa?on of policies Plan data requirements Validate control of informa?on Coordinate delivery efforts Reside in program Work together toward the delivery of information Communicate policies and seeks improvement Data Users Select the best data source Understand the data accessed Comply with data management policies Create data extract to meet specific needs Reside in program Communicate information definition and seeks improvement ideas Share information about applications and technology 8 Data Custodians Capture, store, retain, and dispose of informa?on per owner requirements Design technical infrastructure to meet requirements Verify security of data Reside in IT

9 Project Example: The State of Texas, Health and Human Services A short- and long-term plan supporting Medicaid data governance PROGRESSIVE DATA GOVERNANCE PLANNING APPROACH DATA GOVERNANCE PRELIMINARY PLANNING DATA GOVERNANCE STRUCTURE DEFINITION AND ACTION PLAN DEVELOPMENT ENTERPRISE LEVEL POLICY & PROCESS DEFINITION Data Standards Governance Structure Definition Data Matching Identification of Master Data Areas Solution Concept Assessment Governance Policy Strategic Roadmap Productivity Software Assessment Business Metadata Repository Outline Governance Procedures Change Processes 9 User Training and Education Strategy PROJECT, PROGRAM AREA, OR SYSTEM ALIGNED IMPLEMENTATION

10 Key Success Factors for Data Governance Implementation Obtain executive-level sponsorship Involve stakeholders from key Medicaid programs in data governance discussions Execute a plan that incorporates short- and long-term goals with a vision across the enterprise Use a flexible and robust framework that grows with the life of Medicaid data Plan and deliver consistent communications to stakeholders about data governance capabilities Gain commitment from stakeholders and programs for recommended enterprise data governance standards, processes, frameworks, roles, responsibilities, and agreements 10

11 Questions? 11

12 About Deloitte Deloitte refers to one or more of Deloitte Touche Tohmatsu Limited, a UK private company limited by guarantee, and its network of member firms, each of which is a legally separate and independent entity. Please see for a detailed description of the legal structure of Deloitte Touche Tohmatsu Limited and its member firms. Please see for a detailed description of the legal structure of Deloitte LLP and its subsidiaries. Certain services may not be available to attest clients under the rules and regulations of public accounting. Copyright 2012 Deloitte Development LLC. All rights reserved. Member of Deloitte Touche Tohmatsu Limited

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