Universal Assessment System. Project Status and Advanced Planning Document Summary 2/11/14

Transcription

1 Universal Assessment System Project Status and Advanced Planning Document Summary 2/11/14

2 Project Milestones Date Activity Comment July 2013 Universal Assessment PII IT Team Formed Multi-Division Team Reports to DO, CIO, ITSC, and EC September 2013 Evaluation of COTS Applications Evaluated CH Mack, CIM, and CoCENTRIX Ongoing Assessments by DAAS, DDS, and OLTC Evaluated Functionality Evaluated Three COTS Products October 2013 Initial HP Discussion on MMIS Interface Requirements Begin Definition of Required MMIS System Changes to Accommodate Needs/Functionality October 2013 Drafted System Integrator (NGIT) Statement of Work Incorporated Into APD November 2013 Developed DBHS Assessment Pilot Requirements Ongoing CoCENTRIX Effort January 2014 Evaluation and Decision Point for COTS Solution CoCENTRIX CCP Platform February 2014 April 2014 May 2014 May 2014 July 2014 November 2014 January 2015 Begin Phase 1 Development Finalize Phase 2 Scope and Schedule Phase 1 Testing and Roll Out Phase 2 Development Phase 1 Release Phase 2 Testing and Roll Out Phase 2 Release Phase 1: Will Provide for Intake, Assessments, Plan of Care Development, and Budget Definition Phase 2: Will Provide for Enhanced Interfaces, Additional Provider Functionality, and Full Portal Functions 2

3 Phase 1 Functionality Key Decisions Required Functionality for Phase 1 July 2014 Release (Intake, Assessment, Plan of Care, Budget) Implementation Plan for Subsequent Phases MMIS and EEF System Changes (Updated APD) Life-Cycle Cost Projections and Evaluation COTS Assessment Tool Evaluation of three COTS products Evaluate DBHS CoCENTRIX Pilot DDS and DMS/OLTC Conversion from CH Mack to CoCENTRIX Determine DAAS Conversion from CIM to CoCENTRIX Scope Questions Procurement and Funding Approach for System Integrator/Interface/Configuration (State Staff Augmentation Contract) and COTS Licenses (SHI State Contract) Coordination with EEF/ANSWER Team Scope and Schedule for MMIS Changes Analytics: Outcome Tracking Policy and Approach Finalization EHR Functionality for ASH/AHC/HDCs and Providers 3

4 Primary Function and Interfaces Wavier Functions Function Description Primary System Interfaces (Data Flows) Develop Episodes/Algorithms and Models Referral, Intake, Financial Assessment Conduct Assessments, RUG Scores, Set Budgets Provider Selection or Assignment Plan of Care Development, Transition Plan Service Delivery, Clinical Management, Case Management EHR Functions Outcome Measures, Performance Data Consolidated Tracking, Reporting, Decision Support Determine Reimbursement Adjustment Pay Providers Results of this function are input into. needs to be able to store information. Referral Intake initially recorded in Medicaid Eligibility System. to retrieve intake/application and status. ANSWER/EEF -> provides ability to conduct assessments. Score calculation and budget calculations are provided (where assessment related). is system of record for Assessments/Scores/Budgets. provides assignment of Assessors and Scheduling, Tracking, and Maintenance of Assessments. Budget information -> MMIS. Clients/Providers can view Assessments/Budgets Assessors with Clients, Caseworkers, and Providers Select Provider and Services. is system of record for these selections. -> MMIS Providers Selection -> AR Analytic Engine Selection Case Managers, Clients, Providers agree on provided Services or Transition Case Managers record notes on delivery. Initiate changes in status through ANSWER/EEF or transition process. Record charting service and delivery. Medication Management, Clinical Outcomes, and Pharmacy Management Client-based metrics during service delivery will be collected by and stored at? The AR Analytic engine will store provider-based metrics Standard and custom reports and tracking for client-based information that is system of record Based on provider performance data calculate a Share Gain or Loss. Provides will continue to bill MMIS directly with significant modifications to the process. Provider Adjustments (Quarterly or Annually) will be addressed by AR Analytic Engine and MMIS. Not recorded in. - ANSWER/EEF and Provider Systems AR Analytic Engine, MMIS, EDW AR Analytic Engine MMIS InterRAI-> (Assessments, Screens, Budget) <-> ANSWER/EEF (Financial Eligibility Status, State, Life Changes) -> MMIS -> ANSWER/EEF -> AR Analytic Engine (Budgets, Eligibility Periods, Limits, etc.) -> MMIS -> AR Analytic Engine (Client-Provider data along with Budgets) > ANSWER/EEF (Service Dates) -> AR SHARE -MMIS-AR Analytic Engine- ANSWER/EEF- EDW MMIS -> MMIS -> ANSWER/EEF MMIS will track minimum encounter data from PMPM payments. MDS -> MMIS 4

5 Project Risk and Mitigation Risk # 1 2 Risk Business process requirements are evolving, making development challenging Significant changes will be required to two primary systems MMIS and ANSWER/EEF Potential impact to schedule Mitigation Focus on defined and approved requirements for Phase 1 Communicate status and expectations to stakeholders Define these changes as early as possible Communicate the expected capabilities of Phases 1 and 2 3 Implementation of new Medicaid Wavier Processes will need to be promulgated Potential impact to schedule Divisions are defining these schedules and the PII IT Team will communicate any impacts 4 5 Provider business processes will significantly change under the new PII Medicaid Wavier Processes Customization and development of the COTS package has not been done at an enterprise scale in ADHS Communication to the provider community will be key Assessments and robust pilot testing will help mitigate these risks 5

6 Benefits Benefits Current Methods With UA System Benefit Calculation Intake Referral Applicants Process and Administration Assessments/Provider Selection Service Delivery and Budget, Billing, and Plan of Care More Efficient Medicaid Waiver Staffing Hours (Recurring Benefits) Manual Application thru DCO and Divisions (DAAS,DBHS,DDS,DMS) Manual Application Manual Process Manual Process Automated Online Repository with Controlled Access Online and Disconnected Mode for Application Collection and Validation Online Scoring and Budget Information for Independent Assessors, Nursing Staff, and Conflict Free Case Workers and Others View and Track Plan of Care Online Outcomes and Budget vs. Payments Support Payment Improvement Initiative (One-Time Benefit) 120,000 Applications Year X 1 Hours of Staff Time per Application X $ Average Staff 60,000 Assessments per Year X 1 Hour of Staff Time per Application X $ Average Staff 3,000 Case Managers X 20 Hours per Year Saved X Average Staff 3,000 Case Managers X 5 Hours Saved per Year X $ Average Staff Outcome Tracking Budget Setting Stored in Analytic Engine Not Defined, New Process Recorded in and Available to All Stakeholders Recorded in and Available to All Stakeholders 5,000 DHS Staff and Providers X 3 Hours Savings in Outcome Tracking X $ Average Staff Cost per Hour 5,000 DHS Staff and Providers X 3 Hours Savings X $ Average Staff Payment/Interfaces Not Defined, New Process Interoperable with MMIS and AR Eligibility (ANSWER/EEF) 30,000 DHS and Providers X 2 Hours Savings X $ Average Staff 6