Deliverable 1 - Project Approach and Staffing Plan

QHP/OHP Transition Project Project Approach and Staffing Plan May 22, 2014 Version 1.1 Contract Number 14-‐0011 Project Approach and Staffing Plan Deliverable 1 Document Control Information
Document Identification
Deliverable 1
Client
Cover Oregon
Deliverable Name and Task Item
Project Approach and Staffing Plan
File Name
Deliverable 1 - Project Approach and Staffing Plan v1.1 Response to
Comments.docx
Document Edit History
Version
Date
Additions/Modifications
Prepared/Revised By
1.0
5/14/2014
Initial submission
Annamarie Baca
1.1
5/22/2014
Incorporated state feedback
Dave Turchin
May 22, 2014
Page ii
Cover Oregon
Deliverable 1 - Project Approach and Staffing Plan v1.1 Response to Comments.docx
Project Approach and Staffing Plan Deliverable 1 Table of Contents
1 Background .............................................................................................................................. 4 2 Scope Overview ........................................................................................................................ 4 3 Workstream Structure ............................................................................................................. 5 4 Project Approach ...................................................................................................................... 6 4.1 5 Project Management ........................................................................................................ 6 4.1.1 Project Governance ................................................................................................... 6 4.1.2 Staffing Plan ............................................................................................................... 7 4.1.3 Status Reporting ........................................................................................................ 7 4.1.4 Deliverable Management .......................................................................................... 7 4.1.5 Project Management Tools ........................................................................................ 8 4.1.6 Work Plan .................................................................................................................. 9 4.2 Transition QHP to FFM ...................................................................................................... 9 4.3 Support MAGI Medicaid ................................................................................................. 10 4.3.1 Web Presence Strategy ............................................................................................ 10 4.3.2 Application Intake & Case Management ................................................................. 10 4.3.3 Eligibility & Enrollment Approach ............................................................................ 11 4.3.4 Interfaces Approach ................................................................................................ 13 4.3.5 Data Conversion Approach ...................................................................................... 14 4.3.6 Organization Change Management (OCM) ............................................................. 15 4.3.7 Security .................................................................................................................... 16 Appendix A – Reference Documents ...................................................................................... 18 May 22, 2014
Page 3 of 18
Cover Oregon
Deliverable 1 - Project Approach and Staffing Plan v1.1 Response to Comments.docx
Project Approach and Staffing Plan Deliverable 1 1 Background Cover Oregon is the health insurance marketplace for the State of Oregon, established as Oregon's implementation of the Patient Protection and Affordable Care Act, enabling Oregonians to purchase health insurance at federally subsidized rates. This Project is designed to: • Conduct a Gap Assessment/Requirements Analysis between the existing Cover Oregon Health Insurance Exchange (“HIX”) system (“Cover Oregon HIX Solution”) and the existing Oregon Health Authority (“OHA”) Siebel Integrated Eligibility (“IE”) system as a precursor to transitioning Medicaid eligibility from Cover Oregon to OHA. • Plan work necessary to establish a connection between the OHA Siebel IE system and the Federally Facilitated Marketplace (“FFM”), including connection to the Federal Data Services Hub (“FDSH”) for bi-‐directional account transfer and for Minimum Essential Coverage (“MEC”) verification services. • Develop a strategy for transitioning individual enrollment for Qualified Health Plans (“QHP”) to FFM and begin initial work to transition Oregon to FFM. 2 Scope Overview Starting in November 2014, Oregon’s State Based Marketplace (SBM) will be enabled by Federally Facilitated Marketplace (FFM) technology. The State plans to use the FFM technology (including the portal and call center) for Qualified Health Plans (QHP) eligibility and enrollment. The State plans to retain Medicaid Portal and Call Center, Medicaid Outreach and Education, Medicaid Determination, Enrollment, Redetermination and Appeals, QHP Management and Oversight. This six (6) week assessment is designed to provide an assessment of the current situation and recommend next steps necessary to support Modified Adjusted Gross Income (MAGI) Medicaid based on Affordable Care Act (ACA) requirements. The insights obtained will then be used to develop a roadmap for the execution of the work to be targeted for the remainder of 2014 and 2015. In particular, this assessment will include the following workstreams: May 22, 2014
Page 4 of 18
Cover Oregon
Deliverable 1 - Project Approach and Staffing Plan v1.1 Response to Comments.docx
Project Approach and Staffing Plan Deliverable 1 Develop a strategy for transigoning individual enrollment for Qualiﬁed Health Plans (QHP) to FFM and begin inigal work to transigon the State of Oregon to FFM. Support MAGI Medicaid Deﬁne project methodology, project management approach, and angciapted staﬃng acgviges. Plan and coordinate weekly status reporgng acgviges and oral brieﬁngs. Transigon QHP to FFM Project Management Conduct a Gap Assessment / Requirements Analysis between the exisgng Cover Oregon Health Insurance Exchange (HIX) system (Cover Oregon HIX Solugon) and the exisgng Oregon Health Authority (OHA) Siebel Integrated Eligibility (IE) system as a precursor to transigoning Medicaid eligibility from Cover Oregon to OHA. 3 Workstream Structure May 22, 2014
Application Intake & Case Management
Governance
Eligibility & Enrollment
Methodology
Plan
Plan Management
Broker/Agent/Navigator
Consumer Education and Stakeholder Outreach
Support MAGI Medicaid
Transition QHP to FFM
Project Management
The assessment is being driven by three workstreams: Project Management, Transition QHP to FFM, and Support MAGI Medicaid. The graphic depicts the threads for each workstream. Interfaces (including Account Transfer & MAGI)
Data Conversion
Testing
Reporting
Security
Org Change Management
Solution Architecture & Infrastructure
Page 5 of 18
Cover Oregon
Cover Oregon
Deliverable 1 - Project Approach
and Staffing Plan v1.1 Response to Comments.docx
Project Approach and Staffing Plan Deliverable 1 4 Project Approach Deloitte will employ our Enterprise Value Delivery methodology for the assessment phase of the project. As part of the assessment phase, Requirement Validations Meetings will be held with applicable stakeholders, business subject matter experts (SME’s), functional specialists, and technical teams to validate business and design requirements, perform OHA and Cover Oregon application walkthroughs, and generate buy-‐in among stakeholders on minimum Affordable Care Act (ACA) Modified Adjusted Gross Income (MAGI) Medicaid compliance requirements for November 2014. The figure below depicts the iterative process that will be used to identify the gaps, develop options for bridging the gaps and create with the final roadmap deliverables. Conduct iterative meetings with key stakeholders
Utilize application walkthroughs approach to inform the assessment
Key Inputs
Refine understanding by challenging the existing system
Outputs
CO & OHA Process Flows
Iterative Process
X
X
VAS and one-offs require a new sales package
X
Most roles do not know what sales packages are available to
them
X
4
Sales package definition requires actual costs, and obtaining
actual costs involve some lag time
X
Priority
Root Causes to be Addressed
Non-standard sales package and pricing - constant need to
create new sales packages (most quotes require a new sales
package); even minor content or cost difference must be
treated as a separate sales package
2
3
Priority Override
1
Ppl
ID
Cust
4 weeks
Proc
Baseline
Metrics
Tech
Issue / Symptom
Long quote lead time
Magnitude
Process
Ease of Resolution
CO & OHA Requirements
H
M
1
1
M
L
5
H
M
2
M
2
Issue Group
Services and pricing
standardization
Long quote lead time due to
custom service packages
Services and pricing
standardization; quote-to-cash
process training
Long quote lead time due to
custom service packages
Inconsistent quoting
process
X
M
L
5
Long quote lead time due to
custom service packages
Services and pricing
standardization
X
H
M
2
Long quote lead time due to
custom service packages
Services and pricing
standardization; quote-to-cash
process training
Services and pricing
standardization; quote-to-cash
process training
7
Solutions Managers handoff to C&P Manager and F&C
Manager about new sales packages and tracking is adhoc
and inconsistent
8
FPQs have 45-day validity - if validity is increased, this may
address the quoting workload
9
Workload distribution - some markets may have very high
quoting workload while some others have low quoting
workload
10
Old quotes not tracked / lost (re-work), e.g. because quote
versions are not being tracked and reused
11
Different regions / markets have different people / roles doing
quotes, reporting to different levels / people in the organization
12
Lack of end-to-end quoting ownership
13
FPQ is generated and approved at region level, but customer
PO is issued from national - centralized Cingular purchasing
creates errors due to communication problems/breakdowns
between region and national, e.g. Cingular National may
receive trigger from region to already start creating the PO
based on some version of the FPQ while the region is still
finalizing the work scope, therefore resulting in a PO that is
inconsistent with the finalized agreed-upon FPQ in FOM.
X
X
X
M
H
3
Long quote lead time due to
custom service packages
L
M
5
Insufficient reporting and
metrics for managing the endto-end order process
M
X
X
X
High volume of PO
mismatches (with FPQ
and quantity contract)
40% to 60%
(95% in
Carolinas)
High volume of rework
40%
X
X
Customer PO may not be using the same agreed-upon
version of the FPQ (versioning is sometimes done by using a
new FPQ number, sometimes by adding the version as a
suffix)
X
3
H
3
Insufficient reporting and
metrics for managing the endto-end order process
M
M
4
Lack of understanding and
ownership of the end-to-end
process
Quote-to-cash process training
H
H
1
Lack of understanding and
ownership of the end-to-end
process
Quote-to-cash process
training; Metrics and reporting
H
L
4
Rework associated with QuoteCustomer PO reconciliation
CO & OHA Use Cases
14
15
Sales package may not yet be set up in SAP, and hence not
in the quantity contract
16
Solution Manager is not aware of POs that arrive, and
therefore is not able to track down delayed POs or check if
PO is correct
X
X
X
X
17
Changes can be made to eTracker work packages, but
incorrect work packages deletion can only be handled by
global
X
18
No process for at-risk orders - no PO (NE dummy PO issue),
therefore, customer sends request referencing a PO number
without PO details and an FPQ number that may not yet be
the final FPQ
X
3
Rework associated with QuoteQuote-to-cash process training
Customer PO reconciliation
M
H
M
M
4
Rework associated with QuoteQuote-to-cash process training
Customer PO reconciliation
H
1
Rework associated with QuoteQuote-to-cash process training
Customer PO reconciliation
H
X
Insufficient reporting and
metrics for managing the endto-end order process
H
M
n/a
L
M
5
Rework associated with QuoteQuote-to-cash process training
Customer PO reconciliation
H
M
2
Initiating work without
customer Purchase Order
19
Mismatch between original request and final request - e.g.
with Cingular's EPL process, Nokia now does not have
visibility to equipment delivery/shipment vs. site needs or any
changes Cingular may do / need due to different equipment
configuration
X
X
M
L
5
Lack of understanding and
ownership of the end-to-end
process
20
Site may not be ready, therefore, extra site visits may be
needed
X
X
M
L
5
Lack of understanding and
ownership of the end-to-end
process
High volume of order
changes
Potential
Metric Δ
Services and pricing
standardization
H
Subcontractors may not want to provide costs until the scope
of services is firmed up
Not all sales package info may be ready yet in SAP, but FPQ
is already being generated
Quoting
High quoting volume
Potential Solutions
Long quote lead time due to
custom service packages
X
5
6
Requirements Validation Meetings
Quote-to-cash process training
Order
Management
MAGI Medicaid Eligibility Rules
• Validate and confirm leveragable
Siebel elements from CO and
OHA
• Validate and confirm minimum
requirements needed for ACA
compliance
• Establish scope for all types of
testing
• Develop strategy for external portal
• Comparison of CO & OHA data
models
• Requirements clarification and
catalog update
• Contingency planning for subsequent
work
• QHP to FFM Roadmap
• Requirements Catalog
• MAGI Medicaid
Roadmap
• Web Presence Strategy
• Security Strategy
• Org Change Strategy
4.1 Project Management 4.1.1 Project Governance Deloitte will establish project governance, status reporting, and communication processes for its team in working with the QHP/OHP Project Leadership. As part of this assessment project, Deloitte will track risks, issues, decisions made and discuss them on a regular basis with the QHP/OHP Transition Project Director, Senior Project Manager and members of the State team, as directed by the leadership. Deloitte will perform planning and execution of activities for each workstream as defined in this plan. The progress on these activities will be communicated to the project leadership on a May 22, 2014
Page 6 of 18
Cover Oregon
Cover Oregon
Deliverable 1 - Project Approach
and Staffing Plan v1.1 Response to Comments.docx
Project Approach and Staffing Plan Deliverable 1 regular basis. In addition, Deloitte will coordinate the availability and scheduling of state and contractor resources needed with the project leadership. The assessment related work plans, deliverables, and related documentation will be posted on the client SharePoint site. The work Deloitte is responsible for will be managed via a three-‐tier Deloitte management structure: •
•
•
Project Partners providing senior oversight and subject matter input; A Project Manager planning and coordinating day-‐to-‐day project execution; and Team Leads who each drive the activities and deliverables assigned to their respective teams. Deloitte’s work, the client resources supporting it, and any decisions related to it will be governed by the governance structure established for the overall program. Deloitte will rely primarily on the guidance and approvals provided through the Senior Project Manager, who also serves as Contract Administrator. Deloitte will maintain a Decision and Approval Matrix that captures key functional, technical, policy, and organizational decisions made by QHP/OHP project leadership and use them as assumptions for planning roadmap activities. The decision matrix will include impacted MAGI Medicaid functional areas, their implications, and the status of decision approvals. 4.1.2 Staffing Plan The staffing plan (Appendix A) depicts each planned staff resource to be applied to the effort, onboarding schedule and their associated skill sets. 4.1.3 Status Reporting The status report template (Appendix A) demonstrates the agreed upon status reporting template. Status reports will be submitted on Monday afternoons for the previous week and discussed at the Tuesday morning Status Meeting. 4.1.4 Deliverable Management Per the SOW, the format of formal deliverables will be mutually agreed upon between Cover Oregon’s Contract Administrator and Deloitte before work commences on them. The schedule for approval of Deliverable Expectation Document (DED) will be as follows: Wave 1: (This wave includes the DED’s for the following deliverables) •
•
May 22, 2014
QHP to FFM Roadmap; MAGI Medicaid Requirements Catalog; and Page 7 of 18
Cover Oregon
Cover Oregon
Deliverable 1 - Project Approach
and Staffing Plan v1.1 Response to Comments.docx
•
Project Approach and Staffing Plan Deliverable 1 MAGI Medicaid Roadmap. Process: By Wed., 5/21, Deloitte to submit recommended deliverable templates to Senior Project Manager. By Fri., 5/23, Deloitte and Senior Project Manager to refine templates. By Wed, 5/28, Senior Project Manager to validate templates with key stakeholders (and input from Deloitte if changes are requested by stakeholders.) −
−
−
Wave 2: (This wave includes the DED’s for the following deliverables) •
•
•
Web Presence Strategy; Security Strategy; and Organization Change Mgmt (OCM) Strategy. Process: −
−
By Tuesday, 5/27, Deloitte to submit recommended deliverable templates to Senior Project Manager. By Friday, 5/30, Deloitte and Senior Project Manager to refine and finalize templates. Submission of Deliverables for approval will follow the milestone schedule set forth in the SOW, which is further depicted in section 4.1.6.2 High Level Project Work Plan. An email approval request to the Cover Oregon Senior Project Manager, pointing to the deliverable location on the project SharePoint site, will serve as the formal submission of the deliverable. 4.1.5 Project Management Tools Deloitte will utilize a State SharePoint site to improve communication and collaboration among project team members. May 22, 2014
Page 8 of 18
Cover Oregon
Cover Oregon
Deliverable 1 - Project Approach
and Staffing Plan v1.1 Response to Comments.docx
Project Approach and Staffing Plan Deliverable 1 4.1.6 Work Plan 4.1.6.1 High Level Roadmap F IGURE 1 : H IGH L EVEL R OADMAP W.E.
05/16
Transition to FFM - Medicaid
Week Beg
M
Project
Management
Tu
W
W.E.
05/23
TH
F
M
Tu
W
W.E.
05/30
TH
F
M
Tu
W
W.E.
06/06
TH
F
M
Tu
W
W.E.
06/13
TH
F
M
Tu
W
W.E.
06/20
TH
F
M
Tu
W
TH
F
Project Approach and
Staffing Plan
Weekly Status
Report 1
Weekly Status
Report 2
Weekly Status
Report 3
Weekly Status
Report 4
Weekly Status
Report 5
Final Status
Report
QHP to FFM
Roadmap
Transition
QHP to FFM
Web Presence Strategy
Security Strategy
Support
MAGI
Medicaid
Requirements Catalog
Organization Change
Management (OCM) Strategy
MAGI Medicaid Roadmap
4.1.6.2 High Level Work Plan The high level work plan (see Appendix A) outlines the tasks, durations and associated milestones. 4.2 Transition QHP to FFM The goal of the assessment is to develop a strategy for transitioning individual enrollment for Qualified Health Plans (“QHP”) to FFM and make recommendations for transition of other aspects of Cover Oregon to FFM. •
•
•
May 22, 2014
Plan Management – The plan management workstream is responsible for defining the approach for coordination of activities associated with managing Health Plans to support submission of their plans to SERFF and ultimately for enrollment by customers on the Federally Facilitated Marketplace (FFM). This will include an approach for coordination of CMS and Oregon Insurance Division (OID) timelines, approval of plans by OID, identifying what/how to communicate supplemental plan data to the FFM, certifying plans on the FFM, and providing oversight and assistance to Health Plans throughout the process. Brokers/Agents/Navigators – The focus of this thread is to identify the activities required by Brokers/Agents and Navigators to support the FFM. This includes understanding the Broker/Agent registration process, defining a communication plan, understanding the Navigator certification process, and the team (CCIIO or Oregon) responsible for completing the certification. Consumer Education and Stakeholder Outreach – This thread is comprised of defining the outreach and education needs associated with consumer, tribal, and other constituent groups who need information relative to using the FFM technology. This Page 9 of 18
Cover Oregon
Cover Oregon
Deliverable 1 - Project Approach
and Staffing Plan v1.1 Response to Comments.docx
Project Approach and Staffing Plan Deliverable 1 team will inform the web capabilities Oregon should continue to provide for its customers as part of the transition to FMM. 4.3 Support MAGI Medicaid The goal of the assessment is to conduct a requirements analysis and identify gaps between the existing Cover Oregon Health Insurance Exchange (HIX) system (Cover Oregon HIX Solution) and the existing Oregon Health Authority (OHA) Siebel Integrated Eligibility (IE) system to assess their readiness and make recommendations for transition to FFM participation-‐model. During the assessment of FFM Transition, through the following threads Deloitte will also assess the potential impact on Reporting and Testing. Our analysis will include high level impact on the current Solution Architecture & Infrastructure. 4.3.1 Web Presence Strategy This thread will focus on developing a strategy for the web capability Oregon will continue to provide for its customers who want evaluate their eligibility in MAGI Medicaid. This will include a home page with guidance based on personas, information pages to guide users, a link to healthcare.gov, and the capability to complete a MAGI Medicaid application. •
•
Process: Identify the user work flows to support user information needs and their interaction through required to apply for MAGI Medicaid. Additionally, this will include an assessment of how to integrate these applications into the overall solution for MAGI Medicaid. Infrastructure: Identify the infrastructure and hosting needs required to support the web-‐based capabilities for the MAGI Medicaid and open enrollment periods starting in 2014 and 2015. This includes understanding the existing infrastructure and hosting capabilities, identifying user traffic on the current web site, and identifying the need for infrastructure and hosting capabilities needed to support the future web-‐based capabilities. 4.3.2 Application Intake & Case Management This thread will focus on the assessment of existing capabilities and functionality in the current OHA MAGI Eligibility application instance for collection of application data and map it against the ACA eligibility and enrollment requirements for participation in the FFM. This will include processing of the applications via Account Transfer referrals from FFM, as well as direct applications received for OHP. This analysis includes consideration of the web-‐based needs of Individuals and back office workers processing direct applications for lifecycle management of MAGI cases required under FFM. Our team will follow the following approach: May 22, 2014
Page 10 of 18
Cover Oregon
Deliverable 1 - Project Approach and Staffing Plan v1.1 Response to Comments.docx
•
•
Project Approach and Staffing Plan Deliverable 1 Complete screen and field level review of Cover Oregon and OHA application. Review and refine Cover Oregon and OHA requirements, use case descriptions and process maps. Compile initial use case descriptions and process map inventory. Review and refine use case descriptions and process map inventory. Compile initial requirements inventory for AICM process areas. Review and refine requirements inventory for AICM process areas. Complete fit gap analysis from requirements and OHA application review. Complete data dictionary based on AICM process areas. •
•
•
•
•
•
F IGURE 2 : A PPLICATION I NTAKE & C ASE M ANAGEMENT A PPROACH Application Intake
& Case Management Approach
Inputs
OHA and CO
Design Documents
Meetings with
CMS, CO & OHA
Business & IT
Activities
Analysis
Review Current State
Requirements, Design
and Documentation
Identify the applicable
use case scenarios and
processes for Case
Management
Validate and confirm
leverageable Siebel
elements from CO and
OHA
Identify Prioritized
Scope from Fit Gap
Analysis and Determine
LOE
Identify the applicable
use case scenarios and
processes for
Application Intake
Validate and confirm
minimum requirements
needed for ACA
compliance
Validate Data Dictionary
Complete screen and
field level review of
application
Develop strategy for
external portal
Identify High Priority
Development Areas
from Fit Gap Analysis
CO & OHA
Requirements
Catalog
Outputs
Requirements
Catalog for
Application Intake
& Case
Management
MAGI Medicaid
roadmap for
Application Intake
& Case
Management
Web Presence
Strategy
CMS Documents
and MAGI
Medicaid Eligibility
Rules
4.3.3 Eligibility & Enrollment Approach This thread will focus on the assessment of existing rules coded in the Cover Oregon OPA Rules instance as well as those currently available in the OHA OPA Rules instance for compliance with the MAGI ACA requirements. This will include analysis of related functionality such as client notice generation and enrollment of individuals in the State’s MMIS system. This analysis includes consideration of applications routed from FFE as well as those received directly from the clients for MAGI eligibility. Applications lifecycle management needs of MAGI cases will also play a role to confirm that the OPA rule-‐sets support this business need. Our team will follow the following specific areas of Eligibility and Enrollment in close coordination with the OHA eligibility and policy analysts: MAGI Medicaid/ CHIP Eligibility Determination May 22, 2014
Page 11 of 18
Cover Oregon
Deliverable 1 - Project Approach and Staffing Plan v1.1 Response to Comments.docx
•
•
Project Approach and Staffing Plan Deliverable 1 Validate eligibility Determination approach. Validate key MAGI Medicaid rules using scenarios (Standard Filing Unit composition rules, Financial rules, Non-‐financial rules). Review requirement gaps in Cover Oregon requirements vs. rules in OPA and rules required per ACA. Clarify ambiguous requirements. Conduct gap analysis to determine gaps in OPA rules vs. ACA required rules. Identify gaps in OHA data model vs. required data elements for eligibility determination. •
•
•
•
Enrollment •
•
•
•
Validate enrollment process. Review requirement gaps in Cover Oregon requirements vs. ACA requirements. Clarify ambiguous requirements. Conduct gap analysis to determine gaps in Cover Oregon requirements vs. OHA system functionality. Notices •
•
•
•
Validate Notice generation process/ automation. Review requirement gaps in Cover Oregon requirements vs. ACA requirements. Clarify ambiguous requirements. Conduct gap analysis to determine gaps in Cover Oregon requirements vs. OHA system functionality. F IGURE 3 : E LIGIBILITY & E NROLLMENT A PPROACH Inputs
Activities
MAGI Medicaid/ CHIP Eligibility Determination
OHA and CO
Design Documents
Meetings with
CMS, CO & OHA
Business & IT
CO & OHA
Requirements
Catalog
Validate eligibility
Determination approach
Conduct gap analysis to
determine gaps in OPA
rules vs ACA required
rules
Review requirement
gaps in CO req vs rules
in OPA and rules
required per ACA
Identify gaps in OHA
data model vs required
data elements for
eligibility determination
Enrollment
Validate enrollment
process
Review requirement
gaps in CO
requirements vs ACA
requirements
Conduct gap analysis to
determine gaps in CO
requirements vs OHA
system functionality
Identify gaps in OHA
data model vs required
data elements for
eligibility determination
Analysis
Validate and confirm
leverageable Siebel
elements from CO and
OHA
Validate and confirm
minimum requirements
needed for ACA
compliance
Identify High Priority
Development Areas
from Fit Gap Analysis
Outputs
Requirements
Catalog for
Eligibility &
Enrollment
MAGI Medicaid
roadmap for
Eligibility &
Enrollment
CMS Documents
and MAGI
Medicaid Eligibility
Rules
May 22, 2014
Page 12 of 18
Cover Oregon
Deliverable 1 - Project Approach and Staffing Plan v1.1 Response to Comments.docx
Project Approach and Staffing Plan Deliverable 1 4.3.4 Interfaces Approach This thread will focus on the assessment of new interfaces (e.g. Account Transfer) required in transitioning individual enrollments to FFM as well as any potential impact on the existing interfaces in the current OHA MAGI Eligibility system. These activities will be conducted in close coordination with CMS, OHA, and other state system stakeholders. The assessment will focus on both the functional and technical aspects of the interfaces such as transaction specifications, communication protocols, error handing, and recovery. This analysis includes consideration of applications routed from FFE as well as those received directly from the clients. Applications lifecycle management needs of MAGI cases will also play a role in assessing any potential impact on interfaces. The following steps describe our approach for completion of assessment in this area of the MAGI system readiness: •
•
•
•
May 22, 2014
Build data mapping sheet for data elements (approx. 550) coming from federal system as part of account transfer process. Data mapping sheet specifies functional definition of data element, Cover Oregon Siebel database mapping, OHA Siebel database mapping. It also specifies if this data element is part of fillable pdf and Interview questionnaire. Identify and highlight the data elements which are not present in OHA Siebel database. This is the gap in OHA data model. Identify need for extension of the database to store the additional required data elements captured in the gap analysis. Build and/or modify screens and views to display the additional information. Upon completion of the eligibility determination, send the enrollment information to MMIS. Page 13 of 18
Cover Oregon
Deliverable 1 - Project Approach and Staffing Plan v1.1 Response to Comments.docx
Project Approach and Staffing Plan Deliverable 1 F IGURE 4 : I NTERFACE T RANSITION T O F FM A PPROACH Interface Transition
to FFM Approach
Inputs
CO & OHA Design
Documents
Meetings with
CMS, CO & OHA
staff
Account transfer
& verification
design documents
Activities
Analysis
Review FFM
Account Transfer
interfaces
(Inbound/Outbound)
Review Oregon
Eligibility verification
plan
Validate and confirm
leverageable interfaces
from CO
Review verification
interfaces with FDSH
Review MEC interface
Validate and confirm
minimum interfaces
needed for ACA
compliance
Review OHA to MMIS
interface
Review Data Model for
Account transfer
Review and Confirm
Account Transfer
Payload
Outputs
Update
Requirements
Catalog for
interfaces
MAGI Medicaid
roadmap for
interfaces
Identify the applicable
use case scenarios in
account transfer
Minimum ACA
Compliance
Interface
Requirements
4.3.5 Data Conversion Approach This thread will focus on the assessment of data conversion needs for replacing the Cover Oregon HIX Solution with the FFM and a MAGI Medicaid Eligibility system on the basis of the OHA MAGI Medicaid Solution. The activities in this thread will involve analysis of existing information stored in the Cover Oregon and OHA applications currently serving eligibility and enrollment of MAGI cases. As some of the existing systems (e.g. Cover Oregon Siebel, Cover Oregon OPA, Cover Oregon Peoplesoft, Cover Oregon MDM, Cover Oregon Content Management) are set to retire at the end of the year, MAGI case information stored in retiring applications will need to be preserved or moved over to the new OHA MAGI Eligibility system. The analysis will focus on the completeness, integrity, and accuracy of data stored in these retiring systems to recommend whether a fully automated data conversion is feasible. Any potential impact resulting from the quality of existing data will also need to be considered on the transition and ongoing functionality of the MAGI Eligibility system. These activities will be conducted in close coordination with CO, OHA, and other state system stakeholders. The assessment will focus on both the functional and technical aspects of data conversion such as data extraction, data cleansing, and data verification needs and required tools. The following steps describe our approach for completion of assessment in this area of the MAGI system readiness: May 22, 2014
Page 14 of 18
Cover Oregon
Deliverable 1 - Project Approach and Staffing Plan v1.1 Response to Comments.docx
•
•
•
•
•
•
Project Approach and Staffing Plan Deliverable 1 Review OHA and MDM Siebel data models. Perform Siebelyzer analysis on OHA Siebel database. Identify the data elements required to perform OPA eligibility check. Create data maps that compare the data across multiple OHA applications. Identify the data elements to be transferred from Cover Oregon to OHA application. Define and identify the data sets to be converted from Cover Oregon to OHA database. F IGURE 5 : D ATA C ONVERSION A PPROACH Inputs
CO / OHA Siebel
data model
Meetings with
Oracle & OHA
staff
Activities
Analysis
Review the data
elements required for
performing OPA
eligibility check
Identify the data
elements to be
transferred from CO to
OHA
Review OHA MDM data
model
Create data maps that
compares the data
element across CO &
OHA applications
Identify the data
elements to be
transferred from OHA
Siebel to MDM
Perform Siebelyzer
analysis on OHA Siebel
data model
Define the criteria for
the set of records to be
converted from CO to
OHA
Identify the set of
records to be converted
from CO to OHA Siebel
and MDM applications
Review OHA Siebel data
model
Outputs
Requirements
Catalog
MAGI Medicaid
roadmap
CO & OHA
Technical data
design documents
4.3.6 Organization Change Management (OCM) The Organization Change Management (OCM) team will be using Deloitte’s Enterprise Value Delivery (EVD) methodology that provides guidelines and accelerators supporting the assessment of delivery lifecycles, while promoting consistency, quality and value. Specific tasks will include: •
•
•
•
•
•
May 22, 2014
Capture change impacts in order to support the Change Management and Training activities that will help staff adapt to the system changes. Identify changes related to the People, Process and Technology. Assess the level of impact of that change from High Impact (significant change which will require a substantial Training and Change Management) to Low Impact (requiring some communication but no training). Interview key Cover Oregon and Oregon Health Authority (OHA) to validate our understanding of what types of OCM activities were performed previously including training, communications, and stakeholder engagement. Determine how successful the activities were from the State’s perspective and identify any lessons learned that the State would like to incorporate into OCM activities going forward. Outline the necessary deliverables that align with the identified OCM activities. Page 15 of 18
Cover Oregon
Deliverable 1 - Project Approach and Staffing Plan v1.1 Response to Comments.docx
•
•
Project Approach and Staffing Plan Deliverable 1 Conduct working sessions to determine the full scope of OCM activities as well as the level of effort it will take to complete these activities. Develop a detailed plan for all future OCM activities to guide the OCM work as the team moves into the next phase of the project. F IGURE 6 : P EOPLE , P ROCESS , T ECHNOLOGY People
Process
Changes to…
• Reporting structure
• Department roles
• Tasks/responsibilities for a job
• Positions and classifications
• Competencies and skills
• Workloads
• Work environment
Changes to…
• Processes, sub-processes and
activity changes (As-Is versus
To-Be)
• Process dependencies
• Operational/business concepts
• The way work gets done
• Communication and interaction
Technology
Changes to…
• Applications
• Data or databases
• Security and access
• System performance
• Reporting tools
4.3.7 Security We will use Deloitte’s IT Risk Management Program Assessment methodology in conjunction with CMS MARS-‐E (Minimum Acceptable Risk Standards for Exchanges) Security Controls that provides guidelines and accelerators supporting security, policy and compliance guidelines, while promoting consistency, quality and value. Specific tasks will include: •
•
•
•
•
May 22, 2014
Gather and review existing system documentations to obtain an understanding of the information security controls, policies, and procedures that pertain to the MAGI Medicaid system. Conduct interviews with the system owners and other stakeholders pertaining to the relevant security domains (e.g., information security, system developers, facility users, network engineers, etc.) to assess the areas and identifying the gaps to meet CMS MARS-‐E security controls. Conduct select interviews and walkthroughs of OHA solution hosted datacenters to assess the physical and environmental controls of the hosting facilities. Perform review of the technical vulnerability assessment result including samples of configuration settings and conduct a walkthrough of the existing internal and external network assessment on devices protecting the OHA IE solution environment. Perform review of the existing technical architecture and technical controls available on OHA and identify the gaps that need to be addressed as part of OHA IE solution. Page 16 of 18
Cover Oregon
Deliverable 1 - Project Approach and Staffing Plan v1.1 Response to Comments.docx
Project Approach and Staffing Plan Deliverable 1 F IGURE 7 : S ECURITY A PPROACH The existing OHA technical security controls that will be assessed as part of this review process to identify the gaps related to: •
•
•
•
•
May 22, 2014
Identity & Access Management (IAM) infrastructure for OHA based on Oracle IAM Suite including Multifactor Authentication (MFA), Identity Proofing (IP); Data encryption Technology; Disaster Recover & Backup technology; Security Incident & Event Management system; and Web services Security. Page 17 of 18
Cover Oregon
Deliverable 1 - Project Approach and Staffing Plan v1.1 Response to Comments.docx
Project Approach and Staffing Plan Deliverable 1 5 Appendix A – Reference Documents The following files are referenced throughout the document and will be provided as separate files. File Name
Description
File Type
Deloitte Staffing Plan 2014-05-22 v1_2.xlsx
This spreadsheet identifies specific staff resources that
will be applied to effort, with associated skill sets and
onboarding schedule.
Excel
QHP OHP Transition
Project - Status Report
for Week x Template.pptx
Weekly status reporting will be presented using the
approved template, including tracking of issues and
risks. QHP OHP Transition
Project Work Plan
v1.0.MPP
This document outlines the high level tasks, durations
and associated milestones.
PowerPoint
Project
May 22, 2014
Page 18 of 18
Cover Oregon
Deliverable 1 - Project Approach and Staffing Plan v1.1 Response to Comments.docx
Appendix A -‐ Deloitte Staffing Plan
Name
Team
Onboard date Siebel
Policy Automation (OPA)
Tushar Gupta
Application Intake & Case Management
5/12/14
X
Stephanie Reid
Application Intake & Case Management
5/12/14
X
Jeremy Kellim
Application Intake & Case Management
5/12/14
Jasmin Uribe
Application Intake & Case Management
5/12/14
Rob Dextradeur
Application Intake & Case Management
5/12/14
X
Vivek Dubey
Application Intake & Case Management
5/12/14
X
Kaustubh Dhirde Data Conversion
5/12/14
X
Praneet Raj
Eligibility & Enrollment
5/12/14
Shruti Vasudev
Eligibility & Enrollment
5/12/14
Allan Gibson
Eligibility & Enrollment
5/12/14
X
X
Priya Linga
Eligibility & Enrollment
5/12/14
Swapnil Pathade Eligibility & Enrollment
5/12/14
X
X
Umesh Jadhav
Eligibility & Enrollment
5/12/14
Prasad Y
Eligibility & Enrollment
5/12/14
Hank Chin
Eligibility & Enrollment
5/12/14
Issa Traore
Interfaces (including Account Transfer & MAGI)
5/12/14
Sandeep Chelli
Interfaces (including Account Transfer & MAGI)
5/12/14
X
Bharat Vashi
Interfaces (including Account Transfer & MAGI)
5/12/14
Asrar Rafique
Interfaces (including Account Transfer & MAGI)
5/19/14
X
Jennifer Milligan Org Change Management (includes Training)
5/19/14
CM Sathe
PMO
5/12/14
Sascha Elsing
PMO
5/12/14
X
Manoj Bajaj
PMO
5/12/14
X
Annamarie Baca PMO
5/12/14
Dave Turchin
PMO
5/19/14
X
Kevin Kelly
PMO
5/12/14
TBD
QHP Transition to FFM
5/12/14
Priya Barve
Reporting
5/12/14
Lali Chatterjee
Reporting
5/19/14
X
Bari Faudree
Security
5/12/14
Debi Mohanty
Security
5/12/14
Michael Igbo
Security
5/12/14
Dhiren Patra
Security
5/12/14
Prasad Joshi
Solution Architecture & Infrastructure
6/2/14
X
Solution Architecture & Infrastructure
5/12/14
Jeremy Bartlow
X
Dmitry Katz
Testing
5/12/14
*above core resources will be complemented by offshore resources and additonal onsite resources (as needed)
WebCenter
Master Data Management (MDM)
Business Intelligence Enterprise Edition (OBIEE)
Business Intelligence Publisher (BIP)
Identity and Access Solution Architecture, including Management (IAM)
Technical Architecture and Integration Architecture
Health Insurance Exchange Functionality
MAGI Medicaid Eligibility Functionality
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
Functional Testing
Performance Testing
Program Management
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
Cover Oregon
Weekly status report covering week X
For week ending MMM DD, 2014
Transition Project Director: Tina Edlund
Senior Project Manager: Sarah Miller
Submitted by: Deloitte Consulting
Submission Date: MMM DD, 2014
Version 1
Executive Summary
Overall Status
On Track
Ra*onale: <Add Ra'onale> Key Accomplishments
Key Next Steps
Key Issues/Risks
Status Report for week ending May 16, 2014
1
Copyright © 2014 Deloitte Development LLC. All rights reserved.
Cover Oregon – Status Report Dashboard
#
Week ending MMM DD, 2014
%
Complete
Key Deliverables
Completion
Date
Sign-Off
Date
Status
Workstream #1: Project Management 1.1 Project approach and staﬃng plan 90% May 14, 2014 May19, 2014 1.2 Weekly status report covering week 1 90% May 19, 2014 May 22, 2014 1.3 Weekly status report covering week 2 0% May 26, 2014 May 29, 2014 1.4 Weekly status report covering week 3 0% June 2, 2014 June 5, 2014 1.5 Weekly status report covering week 4 0% June 9, 2014 June 12, 2014 1.6 Weekly status report covering week 5 0% June 16, 2014 June 19,2014 1.7 Final status report covering weeks 1-‐6 0% June 20, 2014 June 25, 2014 10% June 20, 2014 June 25, 2014 Workstream #2: Transi*on QHP to FFM 2.1 QHP to FFM Roadmap Workstream #3: Support MAGI Medicaid 3.1 Web Presence Strategy 10% June 18, 2014 June 23, 2014 3.2 Security Strategy 10% June 18, 2014 June 23, 2014 3.3 Organiza'on Change Mgmt (OCM) Strategy 0% June 18, 2014 June 23, 2014 3.4 Requirements Catalog 10% June 18, 2014 June 23, 2014 3.5 MAGI Medicaid Roadmap 0% June 20, 2014 June 25, 2014 % Complete
Legend
Status
Legend
0% -‐ Not Started 50% -‐ Half-‐way Complete 90% -‐ Submi^ed for Approval 10% -‐ Started 70% -‐ Well Underway 100% -‐ Complete / Approved 20% -‐ In Progress 80% -‐ Submi^ed for Review N Not Started
G
On Track
Status Report for week ending May 16, 2014
Y
Needs attention
2
R At risk of meeting timelines
Copyright © 2014 Deloitte Development LLC. All rights reserved.
Cover Oregon – Status Report Dashboard
#
Week ending MMM DD, 2014
%
Complete
Key Activities
Status
Workstream #1: Project Management 1 Deﬁni'on of Project methodology, Project management approach, and an'cipated staﬃng for ac'vi'es within this SOW 2 Planning, coordina'on, and weekly status repor'ng of ac'vi'es within this SOW On-‐going 3 Daily oral brieﬁngs with Cover Oregon’s Contract Administrator On-‐going 100% Workstream #2: Transi*on QHP to FFM 1 Development of a strategy roadmap for transi'oning individual enrollment for Qualiﬁed Health Plans to Federally Facilitated Marketplace 10% Workstream #3: Support MAGI Medicaid 1 Scoping and recommenda'on of a strategy for interfaces 20% 2 Comparison of data models 20% 3 Requirements clariﬁca'on and catalog update 10% 4 Development of a strategy for the web presence for the Medicaid Eligibility System Front End 10% 5 Hub On-‐Boarding Work & Bi-‐Direc'onal Account Transfer Ini'a'on Work 10% 6 Complete a Security Assessment/Establish Security Strategy 10% 7 Establish scope for organiza'onal change management and training 0% 8 Establish scope for all types of tes'ng 10% 9 Con'ngency planning for subsequent work 0% % Complete
Legend
Status
Legend
0% -‐ Not Started 50% -‐ Half-‐way Complete 90% -‐ Submi^ed for Approval 10% -‐ Started 70% -‐ Well Underway 100% -‐ Complete / Approved 20% -‐ In Progress 80% -‐ Submi^ed for Review N Not Started
G
On Track
Status Report for week ending May 16, 2014
Y
Needs attention
3
R At risk of meeting timelines
Copyright © 2014 Deloitte Development LLC. All rights reserved.
Appendix
Status by Team
Leads: <Names>
Status by Team
Workstream #1: Project Management Team
Accomplishments (prior week)
Upcoming Work (current week)
Issues/Risks
•  None Status Report for week ending May 16, 2014
5
Copyright © 2014 Deloitte Development LLC. All rights reserved.
Leads: <Names>
Status by Team
Workstream #2: QHP Transition to FFM Team
Accomplishments (prior week)
Upcoming Work (current week)
Issues/Risks
•  None Status Report for week ending May 16, 2014
6
Copyright © 2014 Deloitte Development LLC. All rights reserved.
Leads: <Names>
Status by Team
Workstream #3: Application Intake & Case Management Team
Accomplishments (prior week)
Upcoming Work (current week)
Issues/Risks
•  None Status Report for week ending May 16, 2014
7
Copyright © 2014 Deloitte Development LLC. All rights reserved.
Leads: <Names>
Status by Team
Workstream #3: Eligibility & Enrollment Team
Accomplishments (prior week)
Upcoming Work (current week)
Issues/Risks
•  None Status Report for week ending May 16, 2014
8
Copyright © 2014 Deloitte Development LLC. All rights reserved.
Leads: <Names>
Status by Team
Workstream #3: Interfaces & Data Conversion Team
Accomplishments (prior week)
Upcoming Work (current week)
Issues/Risks
•  None Status Report for week ending May 16, 2014
9
Copyright © 2014 Deloitte Development LLC. All rights reserved.
Leads: <Names>
Status by Team
Workstream #3: Security Team
Accomplishments (prior week)
Upcoming Work (current week)
Issues/Risks
•  None Status Report for week ending May 16, 2014
10
Copyright © 2014 Deloitte Development LLC. All rights reserved.
Leads: <Names>
Status by Team
Workstream #3: Solution Architecture & Infrastructure Team
Accomplishments (prior week)
Upcoming Work (current week)
Issues/Risks
•  None Status Report for week ending May 16, 2014
11
Copyright © 2014 Deloitte Development LLC. All rights reserved.
Leads: <Names>
Status by Team
Workstream #3: Testing Team
Accomplishments (prior week)
Upcoming Work (current week)
Issues/Risks
•  None Status Report for week ending May 16, 2014
12
Copyright © 2014 Deloitte Development LLC. All rights reserved.
Leads: <Names>
Status by Team
Workstream #3: Reporting Team
Accomplishments (prior week)
Upcoming Work (current week)
Issues/Risks
•  None Status Report for week ending May 16, 2014
13
Copyright © 2014 Deloitte Development LLC. All rights reserved.
Leads: <Names>
Status by Team
Workstream #3: Org Change Management Team
Accomplishments (prior week)
Upcoming Work (current week)
Issues/Risks
•  None Status Report for week ending May 16, 2014
14
Copyright © 2014 Deloitte Development LLC. All rights reserved.
About Deloitte
Deloitte refers to one or more of Deloitte Touche Tohmatsu, a Swiss Verein, and its network of member firms, each of which is
a legally separate and independent entity. Please see www.deloitte.com/about for a detailed description of the legal structure
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legal structure of Deloitte LLP and its subsidiaries.
Copyright © 2014 Deloitte Development LLC. All rights reserved.
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