Part 4 - Iowa Medicaid Enterprise

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RFP MED-12-001 | Technical ProposalIowa Medicaid Enterprise System Service Procurement | MMIS and Core MMIS OperationsNoridian and the IME through service level agreements (SLAs) and key performance indicators (KPI).The New MMIS will provide the necessary data, which will be used to verify that the SLAs are beingmet. The MMIS will support IME by providing operational and performance data plus reports forproviding visibility and insight into the claims processing business area performance characteristics.Team Noridian uses a performance dashboard, eCAMS HealthBeat, to monitor performance. Theperformance dashboard monitors and inspects appropriate measures, such as inventory levels, thatposition Team Noridian to meet the performance expectations. This inspection and identification of highinventory levels is an important step to meeting the overall performance requirements. Team Noridian canquickly address and reduce high inventory levels that, if not reduced, jeopardize timely performance.Reporting of Data to Support Oversight, Administration, Evaluation, Integrity, and Transparency.eCAMS is a proven and operational system that is certified in the State of Washington and Michiganusing the new CMS certification toolkit. It provides extensive reporting capabilities that are thoroughlyused in the MMIS operations at the multiple installations. eCAMS produces electronic reports thatprovide accurate data necessary for oversight, evaluation, integrity and transparency of MMIS operations.The reports generated are stored in a document management repository and made available for theoperational usages. These reports will be delivered to external subscribers such as designated federalrepositories or data hub through the eCAMS interfaces framework.HIE and Other External System InterchangeTeam Noridian’s proposed solution includes implementing an integration hub infrastructure that isdecoupled from the replacement system and the legacy system, as shown in Figure 9-10. It is built on theproven eCAMS solution architecture and leverages the EXACT infrastructure framework. The solution isaligned with current and future industry interoperability standards through Team Noridian’s participationin MITA and HL7 standards as well as our continued participation in other key interoperability standardsand projects.Figure 9-10. Conceptual Design of Integration Hub for HIE. Independent interoperability throughstandards-based interoperability profiles preserves investment in Department IT assets.9 | 20
RFP MED-12-001 | Technical ProposalIowa Medicaid Enterprise System Service Procurement | MMIS and Core MMIS OperationsOur solution design is built on a hub model that provides the business partners and external entitiesexchanging health information data, a single reference point. The implementation allows theinfrastructure to remain independent of the legacy or the replacement system, and can further easily beintegrated with other SOA infrastructures that may exist in other state departments. The EXACT SOAframework also provides capabilities in the form of deployable adapters that ensure interoperability. Forthose entities not capable of directly using the standard interoperability transactions, an adapter will havea set of custom transactions between the adapter and the participating system, where it will map the datato the standard transaction that goes to the hub. This isolates the custom work to connect to the hub to asmall adapter, and allows the hub to operate independent of any required customization for non-standardparticipating systems. The EXACT framework provides a standards-based, open, extensible platform fordeveloping software infrastructures using a SOA approach. This unified and comprehensive suite can helpcreate composite applications from existing investments, as well as deliver new business services in aflexible SOA environment with no vendor lock-in, through development in the EXACT community.9 | 21
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Part 4 - Iowa Medicaid Enterprise

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