medicaid enterprise management system rfp pre-release vendor conference
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Medicaid Enterprise Management System RFP Pre-Release Vendor Conference 101 Cold Harbor, Frankfort, KY Thursday 01/24/2013 2:30 pm to 5 pm . - PowerPoint PPT PresentationTRANSCRIPT
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Medicaid Enterprise Management SystemRFP Pre-Release Vendor Conference
101 Cold Harbor, Frankfort, KYThursday 01/24/2013
2:30 pm to 5 pm
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Welcome to Kentucky and Introductions
Kentucky’s Strategic Vision for Healthcare Transformation
Medicaid Enterprise Management System RFP Structure and Scope
Medicaid Enterprise Management System Vendor Procurement Tentative Timeline
Medicaid Enterprise Management System Implementation Timeline
Open Questions and Feedback
Kentucky Medicaid Enterprise Management System RFP Pre-release Vendor Conference
Discussion Outline
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Kentucky has developed a complete and achievable eHealth IT Architecture.
Kentucky has a consolidated Cabinet organization that encompasses all of the program pillars depicted in our vision.
CHFS Secretary Haynes and Governor Beshear have been engaged and aggressive in our efforts to improve healthcare in Kentucky and nationally.
Early adoption of HIE, GOHIE, HBE, etc.
Focus on improved delivery and quality of healthcare through Managed Care and push to streamline MMIS.
Kentucky’s Strategic Vision for Healthcare Transformation
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QHI Components for CHFS Supported Systems:
Citizen, Worker, Partner Web Portals
SharePoint Document Management System
Corticon Business Rules Engine
BizTalk Enterprise Service Bus
IBM Infosphere Master Data Management
SAS Fraud Analytics
KEUPS Seamless Security Services
HP Exstream Fulfillment
Kentucky’s Strategic Vision for Healthcare Transformation
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Option 1 MEMS System Replacement:Design, development, implementation and maintenance of the new Kentucky Medicaid Enterprise Management System and Fiscal Agent.
Proposed solutions and pricing for the following “Options to Buy”:•System Hosting and Disaster Recovery services•Decision Support System•Utilization Management Services
Option 2 MEMS System Takeover:Planning, migration and operations necessary to assumethe operation of the current MMIS and Fiscal Agent services.
Option 3 Combined MEMS System Replacement and Takeover:Providing of all services necessary for Options 1 & 2. (Takeover and Replacement)
Medicaid Enterprise Management System RFP Structure and Scope
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Medicaid Enterprise Management System RFP Structure and Scope
Seamless data exchange of information within QHI framework including as close as possible to real-time integration with Kentucky Health Benefits Exchange System.
Optimization of Managed Care Relationships and streamlined support for remaining Fee for Service processes.
SOA based solution comprised of components that integrate into the Commonwealth’s SOA framework or directly utilizes the Commonwealth’s components.
MITA based modular solutions from a single Vendor or a “best-of-breed” multi-vendor solution.
Meets CMS certification requirements as defined in the CMS MECT.
Comprehensive data management strategy that organizes all of the data and enables easy access to information.
Configurable and extendible solution to cost-effectively support Kentucky’s future expansion of programs and populations, and to meet current and future regulatory needs.
The Commonwealth requires that the future Medicaid Enterprise Management system be built using the following principles:
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Medicaid Waiver Management Application
Pharmacy Benefit Management
Not in RFP Scope:
Medicaid Enterprise Management System RFP Structure and Scope
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The functional requirements cover the business operations of the enterprise. These requirements are grouped as follows:
Business Relationship Management
Care Management
Contractor Management
Financial Management
Member Management Lite
Operations Management
Program Management
Program Integrity Management
Provider Management
Medicaid Enterprise Management System RFP Structure and Scope
February March April
06 13 2004 11 18 25 04 11 18 25 08 2915 2201 27
Vendor Solicitation
May
06 13 20 27
June
06 13
July
Vendor Selection
Release RFP
Vendor written questions
Ky written responses
Vendor Conference /
Vendor QuestionsKy written responses
Proposals Due
Vendor Orals/DemosFinal Scoring
Vendor Selected
Proposals Scored
MEMS Procurement Tentative Timeline
Open Questions and Feedback