Part 4 - Iowa Medicaid Enterprise

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RFP MED-12-001 | Technical ProposalIowa Medicaid Enterprise System Service Procurement | MMIS and Core MMIS OperationsTeam Noridian has also implemented EXACT in the commercial market and for CMS in theMedicare program.Today's unsettling economic environment affects businesses and federal and state agencies equally.Combined with the demands of provider and member clients, meaningful collaboration among allparticipates in the health care delivery system is a fundamental necessity for the Department and itsprovider and member clients.Team Noridian's new MMIS, while certainly meeting all of the technical requirements set forth in theDepartment's RFP, also provides an adaptability, scalable, and technology agnostic framework that willenable the Department to mature along the MITA continuum and begin meaningful participation in theemerging collaborative health care consortium at the state and federal level.The interoperability framework of Team Noridian’s new MMIS is the EXACT SOA infrastructureframework. EXACT manages the connectivity and standardizes the exchange of data between the newMMIS and heterogeneous peripheral systems, both internal and external to the Department. EXACTsupports the modular design of the new MMIS and promotes a truly interoperable environment byeliminating the technology barriers that often hamper meaningful communication between disparatesystems. EXACT delivers the industry-leading infrastructure needed to integrate silo applications andsystems into a coherent health care administration delivery platform.The EXACT SOA framework provides several functions that add tremendous value to the new MMIS forthe Department, including:• Enterprise Service Bus• Integration Services• Rules ServicesIn addition to these important function, by using EXACT as its integration and connectivity framework,Team Noridian delivers to the Department expanded capabilities that support MITA Level 3 standards,and the ability to support the technology and standards that will facilitate the collaboration, sharing, andexchange necessary for Level 4 and 5 maturity.The main component of the new MMIS is the proven and operational eCAMS health care administrationplatform, which is certified in the State of Washington and Michigan using the new CMS certificationtoolkit. eCAMS is built around a service-oriented architecture where the business services (aligned withMITA architecture) are augmented with technical and infrastructure services. The platform providescomplete end-to-end business functionality to support both traditional Medicaid delivery models (Fee-for-Service and Managed Care) and evolving delivery models like community care. The platform not onlydelivers out-of-the-box Federal CMS certification requirements but also leads the industry in its alignmentwith MITA principles. eCAMS has evolved its user interface and user experience to more positively engagewith the provider and member community. eCAMS continues to improve its user experience and add newchannels such as smart phones to make the information ever more open and ubiquitous.One of the foundational aspects of building a platform with eCAMS and not implementing a stand-alonesystem or application is the de-coupling of business rules and data exchange. eCAMS is built around aservice-oriented architecture where the business services (aligned with MITA architecture) are augmentedwith technical and infrastructure services. eCAMS and the EXACT SOA infrastructure framework bringto the Department a robust health care platform which provides the foundation for its service-orientedarchitecture (SOA) infrastructure.Team Noridian understands that security and privacy are critical elements to Medicaid operations. Theproposed solution supports a robust privacy and security architecture which consists of multiplecomponents that reinforce privacy and security policies, procedures, and guidelines.9 | 2
RFP MED-12-001 | Technical ProposalIowa Medicaid Enterprise System Service Procurement | MMIS and Core MMIS OperationsTeam Noridian believes that the new MMIS built on these proven components and powered by theeCAMS platform provides the state of Iowa with the necessary tools for business flexibility, improvedoperational process efficiencies, and a cost effective way of implementing future system changes. Thenew MMIS will provide a robust platform for the Department to embrace future innovations, policychanges, and break-through in health care delivery. The new MMIS architecture provides a businessdrivenframework and facilitates a higher level of MITA maturity that is interoperable, standards-based,and flexible.Our approach in developing the eCAMS's system architecture for the new MMIS has been to continuallyfocus on the larger frame of reference and not focus specifically on individual technologies. Technologieschange rapidly. A system that focuses on standards, frames of reference, and core architectural principlesis by nature more resilient and sustainable for the long life cycle of an MMIS.Figure 9-1 shows a more detailed view of the different components showing access channels, backendinfrastructure of the proposed solution and their high level interactions between the components.Figure 9-1. Conceptual Overview of the new MMIS and its Building Blocks. The new MMIS publishesand consumes all interfaces through the EXACT framework, extending the power of the eCAMS healthcare administration platform across the IME.9 | 3
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Part 4 - Iowa Medicaid Enterprise

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