The MITA State Self Assessment (SS-A) is a process that a State uses to review its strategic goals and objectives, measure its current business processes and capabilities against MITA business capabilities, and ultimately develop target capabilities to transform its Medicaid enterprise to be consistent with MITA principles.The SS-A has four main purposes:
1. Map the State’s business processes to the Medicaid business processes as they are described in the Framework document
2. Define the State’s current level of business capability maturity (the “as-is” status)
3. Identify the target levels of business maturity that the State hopes to achieve in the future (the “to-be” status)
4. Serve as input to the Transition Plan
A dilemma facing many States as they embark on completing the MITA SS-A is just how far into the future to go when identifying their “to be” capabilities. It is tempting to aim high and identify levels 4 and 5 maturity for all business processes to demonstrate that the State is going to have a “super system” that complies with the all of the principles of interoperability and health care data exchange…but is this vision realistic or even helpful in designing a new system or preparing the procurement documentation that will drive the transition?
Probably not.
Keep in mind that the results of the SS-A are going to be used to drive the State’s Transition Plan. The main component in the transition plan is the gap analysis. In developing the gap analysis, the State will compare their “as-is” maturity capabilities to their target “to-be” capabilities and then identify the scope of work and the level of technical support that will be required to make the transition. The scope of work and technical architecture will in turn drive the cost estimate for the project. All of this then comes together to help prepare an Implementation APD to request Federal dollars and as input to the RFP process.
So how far into the future should a State project the “to-be” levels of business maturity when conducting an SS-A? In my humble opinion, not beyond what is reasonably achievable over the next 2-5 years based on technology enablers and budget constraints. For many State’s, this means moving only to level 2 or level 3 maturity level for the business processes that will be affected by the transition or enhancement. Keeping the “to-be” targets realistic will not only promotes better planning, it will also result in better proposals from vendors in response the RFP.
It IS important for State’s to have a long term strategic plan that describes where the State would like to be in terms of business maturity 10 years from now; but this vision does not belong in the SS-A. This vision belongs in the concept of operations document or even as a separate section of the transition plan. Having this well-defined concept of the future of the Medicaid enterprise will help to ensure that any shorter-term enhancements or replacements will be in line with where the State wants to be down the road. But for the SS-A, stick to what is achievable within the span of the next procurement.
4 comments:
Great post, Mikey. Especially for one made at 2:33 AM. I'm going to print it, re-read it, and share it with our management team. Thanks!
andy: glad to hear you found the post useful! Thanks for the comment.
I definitely agree what gets identified "To Be" in the next 5 years is most critical, especially for the states looking to make signficant changes in that timeframe with a new MMIS or maybe adding in PHR or EHR. However, I would also say that any state that has gathered enough internal momentum to get started with MITA may only get this one window of opportunity to baseline that longer-term view. If it turns out they need to put it in their SS-A to keep it visible, so be it. Since the SS-A is a "living" document (I hope) it can still be updated over time if the original vision goes too far. Placing that long-term view in another document would also be OK, but I think it adds complexity some organizations aren't "mature" enough to deal with. I would expect, unfortunately, that separate documents will drift apart over time, especially when one is needed for enhanced FFP and the other is not.
Astute observations mita-naut. I have one comment with regard to the FFP consideration. The CMS folks doing the review of the APD will need to be able to separate the to-be levels of maturity in the SS-A that should be considered in the funding request from the to-be levels that are part of a longer-range strategic plan, as this may not be clearly evident. I suspect that this can be addressed in the needs assessment portion of the APD document, but I am not sure. Adding to the complexity here is the differing expectations among the CMS regional office staff who are performing the APD reviews. I think that it will all come together in time, but it will take teamwork and patience.
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