MMIS Solutions:   A New Approach to Forming MMIS           Project TeamsThis white paper contains data that shall not be d...
MMIS Solutions: A New Approach to Forming MMIS Project Teams                                                              ...
MMIS Solutions: A New Approach to Forming MMIS Project Teams                                                              ...
MMIS Solutions: A New Approach to Forming MMIS Project Teams                                                              ...
MMIS Solutions: A New Approach to Forming MMIS Project Teams                                                              ...
MMIS Solutions: A New Approach to Forming MMIS Project Teams                                                              ...
MMIS Solutions: A New Approach to Forming MMIS Project Teams                                                              ...
MMIS Solutions: A New Approach to Forming MMIS Project Teams                                                              ...
MMIS Solutions: A New Approach to Forming MMIS Project Teams                                                              ...
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MMIS Solutions: A New Approach to Forming MMIS Project Teams

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It’s not just about filling the boxes on your organization chart – it’s about forming a project team that ensures the success of your MMIS project. Among the most important phases of the MMIS Design, Development and Implementation (DDI) project is the planning phase, and within the planning phase, there is no more important step than establishing a strong MMIS DDI project team. The project team represents the most important contributing factor to the success or failure of the MMIS DDI project. While the approach to forming an MMIS DDI project team may seem similar to other state information technology (IT) projects, it is far from the norm. The size, complexity and risk associated with MMIS DDI projects require a greater level of detailed planning and creativity when forming the project team .

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MMIS Solutions: A New Approach to Forming MMIS Project Teams

  1. 1. MMIS Solutions: A New Approach to Forming MMIS Project TeamsThis white paper contains data that shall not be duplicated, used, or disclosed in whole or in part without the express permission of Cognosante. Copyright© 2012.
  2. 2. MMIS Solutions: A New Approach to Forming MMIS Project Teams October 2012 ContentsINTRODUCTION ............................................................................................................................................ 1BUILDING THE BEST PROJECT TEAM......................................................................................................... 1RESOURCE ASSIGNMENT............................................................................................................................. 2A SUCCESSFUL PROJECT TEAM – KEY ROLES .......................................................................................... 3KEY CHALLENGES ....................................................................................................................................... 4A NEW APPROACH....................................................................................................................................... 4THE BENEFITS OF SUPPLEMENTING YOUR TEAM..................................................................................... 5MOVING AHEAD WITH YOUR MMIS DDI PROJECT ................................................................................. 6CONTACT INFORMATION ............................................................................................................................ 6AUTHORS ...................................................................................................................................................... 7 ExhibitsExhibit 1. Sample MMIS DDI Project Team Organization .......................................................................... 3Exhibit 2. MMIS DDI Project Team Staffing Challenges ............................................................................ 4Exhibit 3. Benefits of MMIS DDI Project Team Contracted Support .......................................................... 6 Use or disclosure of data contained on this sheet is subject to the restriction on the title page of this white paper. ii
  3. 3. MMIS Solutions: A New Approach to Forming MMIS Project Teams October 2012INTRODUCTIONIt’s not just about filling the boxes on your organization chart – it’s about forming a project team thatensures the success of your MMIS projectAmong the most important phases of the MMIS Design, Development and Implementation (DDI) projectis the planning phase, and within the planning phase, there is no more important step than establishing astrong MMIS DDI project team. The project team represents the most important contributing factor to thesuccess or failure of the MMIS DDI project. While the approach to forming an MMIS DDI project teammay seem similar to other state information technology (IT) projects, it is far from the norm. The size,complexity and risk associated with MMIS DDI projects require a greater level of detailed planning andcreativity when forming the project team. Utmost, MMIS project success requires the following:Strong Leadership. The MMIS DDI project team should include – at a minimum – strong executiveleadership, project management expertise in multiple functional areas and subject matter experts who caneffectively represent the organization’s business and IT needs.Ability to Meet Challenges. States have typically formed their MMIS DDI project teams by tappingtalent from within the organization, which often occurs at the expense of operational units that supportday-to-day business. In addition to staffing obstacles, there are multiple healthcare initiatives underwaythat demand staff attention. Both limited depth within state organizations and strained budgets haveresulted in hiring limitations. These and other challenges have forced states to be creative and consideralternative strategies for MMIS DDI project team formation.Recently, state procurements have been calling for project management services that require contractorsto fill the majority of the MMIS DDI project team’s key positions. As states weigh the value ofcontracting out for these services, consideration should be given to the risks associated with forming anunderstaffed and inexperienced MMIS DDI project team compared to contracting out – an approach thatrequires a marginal state investment and leverages enhanced federal financial participation (FFP). Thelatter outcome is an experienced project team that reduces project risk by providing professional projectmanagement services equipped with MMIS-specific expertise, tools, templates and maximum flexibilityto increase the likelihood for project success.BUILDING THE BEST PROJECT TEAMAs states look to form their MMIS DDI Project Team, focus should be placed on the following:Sponsor Recognition of Project Complexity, Risk, and Need for Effective Management. Executivesmust recognize the importance of forming a strong MMIS DDI Project team and support strategies toensure that the team is adequately staffed and in place prior to the start of the project and remain staffedthroughout the project.Forming a Highly Collaborative and Effective Team. MMIS DDI projects require the formation of ahighly collaborative team comprised of leadership from the sponsoring organization, experienced projectdirectors and managers, subject matter experts, support staff and vendors. The most successful projectteams often consist of a wide range of members, from executives to frontline staff. Typically, this is theinitial strategy used. States often, however, do not have adequate staffing to fill every position, whichmakes building the right team difficult as there is a significant cost to the daily operations of theorganization when staff are redeployed.Team Composition and Roles. It is important that project team members embrace the team environmentand understand their roles and responsibilities. In addition to the programmatic expertise required, thereare also a number of formal project management roles that team members must play that are critical to theMMIS DDI Project, such as providing periodic status updates, reviewing deliverables and participating in Use or disclosure of data contained on this sheet is subject to the restriction on the title page of this white paper. 1
  4. 4. MMIS Solutions: A New Approach to Forming MMIS Project Teams October 2012testing activities. Team members with formal Project Management Professional (PMP) certification andexperience are highly recommended.Communication and Collaboration. The size and complexity of today’s MMIS DDI Projects demandmaximum communication and collaboration both internal and external to the sponsoring organization. Astrong MMIS DDI team needs to possess the knowledge, skills and abilities to ensure timely and accuratecommunication and to cultivate an environment of trust. Shared or common goals must be developed tofoster this collaboration among all project stakeholders.Identification and Removal of Project Barriers. Typically, human service organizations function in asiloed environment where communication is not optimal. Program areas and departments have differentagendas and clients, and this can present challenges to the project. These challenges and barriers must beanticipated and addressed strategically. The project team must be able to develop shared goals andovercome obstacles.Meeting the State’s Obligation to the DDI RFP and Contract. The MMIS DDI procurement andcontract document will likely have state responsibilities, deliverables and schedules that vendors willexpect the state’s project team to meet. States must pull together a project team that is capable of meetingthese vendor expectations. It may be wise if not required for the State project team to have complimentaryroles that match the DDI vendor’s project team’ s organization and project phasesRESOURCE ASSIGNMENTWhen it comes to building your MMIS DDI project team, the old adage “actions speak louder thanwords” really means something. Has the MMIS DDI project team been resourced properly? That is, hassuitable talent been selected for the appropriate roles and what is the commitment level? Is the resourceassigned to the project at a level of 100 percent, 75 percent, 50 percent or less? The MMIS DDI projectwill only be successful if you have aligned the right expertise in the right positions for the proper amountof time.States should carefully consider how they assign resources for the core MMIS DDI project team functionsdescribed below Acceptance Test Management. Often, this is a challenging activity for any MMIS DDI project. Test Management requires experience and expertise, and significant resources are needed to perform testing as well as manage the testing process. Business Change Management. There will be significant changes to business operations that must be managed. Certification Management. It’s never too early to begin planning for CMS certification. These activities must be planned before “Go-Live” and must be executed immediately after implementation. Communication Management. Project communication, both internal and external must be planned and executed throughout the project. There also is a significant amount of communication needed for key stakeholders like providers and member that will be significantly impacted by the new MMIS operations. Data Conversion Management. Conversion of legacy data must be carefully planned, executed and monitored to assure integrity in the new system. Conversion problems must be resolved early on and in a timely manner. DDI Contract Management. The size and value of the DDI contract requires significant management and oversight of project deliverables, service-level agreements, and contract issues and amendments. Use or disclosure of data contained on this sheet is subject to the restriction on the title page of this white paper. 2
  5. 5. MMIS Solutions: A New Approach to Forming MMIS Project Teams October 2012 Financial Management. Large state and federal budget allocations and multiple vendor invoices make financial management a full-time activity. Updates must be provided to CMS and related to the Implementation Advanced Planning Document. Implementation Management. There are many key activities to be planned and managed leading up to and following the “Go-Live” of the new system and operations implementation date. Issue/Risk Management. A robust issue and risk management process must be developed and managed effectively. Project Management. Every MMIS DDI project should have an executive-level project director and deputy project manager(s) to effectively direct strategic decisions and oversee status reporting and day-to-day project activities.PMP certified project managers are ideal. Quality Management. Oversight of the quality of project deliverables and other aspects of the projects such as configuration must be performed to assure good results and avoid re-work later in the project. Schedule Management. The integrated project schedule must be developed and managed as well as assuring the DDI vendor’s schedule is closely monitored. Scope Management. Project success is directly related to how well the MMIS DDI project team manages scope. A rigorous process and effective tools are essential. Team Management. With multiple roles and responsibilities, day-to-day team management and leadership are criticalA SUCCESSFUL PROJECT TEAM – KEY ROLESIn Exhibit 1, a basic MMIS DDI project organization is presented. The composition includes keyfunctional roles that are critical to MMIS DDI projects, some of which are described below: Deputy Project Manager. Reports to project director and responsible for day-to-day management. Senior Medicaid Leads. Provide subject matter expertise and coordinate department SME participation. Quality Assurance Manager. Manages overall project quality, configuration and change management. Schedule/Cost Manager. Manages overall schedule and budget for the project. Exhibit 1. Sample MMIS DDI Project Team Organization Communications and Training Manager. Responsible for internal and external communications and training. Senior Medicaid Systems Analyst. Provides technical analysis and expertise in MMIS vendor systems and represents the MITA business areas and processes. Use or disclosure of data contained on this sheet is subject to the restriction on the title page of this white paper. 3
  6. 6. MMIS Solutions: A New Approach to Forming MMIS Project Teams October 2012 Test Manager. Responsible for managing overall testing effort and coordinating user acceptance testing.It is important to note that project scope and complexity will dictate the necessary size of the MMIS DDIproject team. Team composition will vary based on whether the project is an MMIS takeover, modularenhancement or full replacement. The state DDI project team may want to mirror the vendor project teamin size and complexityKEY CHALLENGESStates that are unable to address staffing challenges typically form MMIS DDI project teams that are ill-equipped to manage a large, complex, expensive, lengthy and political MMIS DDI Project. Some of thecommon challenges that state agencies should be aware of are listed below. MMIS DDI Project Team Staffing ChallengesUnderestimating Estimating the true size and scope of an MMIS Project is challenging.staffing needs Unfortunately, underestimating staffing results in an MMIS DDI project team that is too small and can quickly become overwhelmed by the multiple project activities and deliverables.Lacking cohesive executive The MMIS DDI project touches a large portion of the human services enterprise.leadership For this reason, the project must be supported at the highest executive level with solid governance. Lack of cohesive executive leadership can result in the MMIS DDI project team struggling to receive adequate participation from competing program areas and delays in key decisions.Inexperienced Project Managers States may have staff who have lead smaller projects or initiatives but do they may not have formal Project Management training, certification and experience. Leading a MMIS project is more challenging than most other State projects. A strong lead business analyst or operations manager does not always make a good project manager. Experienced project managers, preferably with PMP certification should be on the MMIS DDI team to ensure project management standards and best practices are followed.Difficulty finding the Typically within the state, the best and brightest on staff are already leading andright skills and experience to fill managing high-priority areas that are essential to supporting daily operations.key positions While some MMIS DDI project staff with the right mix of skills and expertise will join the MMIS DDI project team to fill key positions, it will be at a cost to the organization, which will need to backfill these vacated positions.Lengthy hiring process Faced with having to recruit MMIS DDI project team members, states often must wade through a lengthy hiring process that can take up to six months. This can result in delays even before the project begins.Personnel policy constraints States often face personnel requirements that are challenging to navigate − from lengthy multi-stage hiring and salary exception processes to “limited-duration” positions and outright hiring freezes. These and other personnel policies create obstacles to filling key MMIS DDI project positions.Staff turnover State staff members with significant expertise and knowledge are retiring. Additionally, election results can play havoc with senior management positions and operational demands can quickly pull key staff away from project work. Also staff can burn out quickly due to challenging and lengthy nature of MMIS projects. Exhibit 2. MMIS DDI Project Team Staffing ChallengesA NEW APPROACHToday’s healthcare environment is rapidly evolving. States are scrambling to keep up with a plethora ofnew federal mandates, policy changes and initiatives, such as ICD-10, adoption of certified ElectronicHealth Record (EHR) technology and health information exchanges. Given the multiple initiativesunderway designed to improve Medicaid systems, combined with the daunting size, complexity and risk Use or disclosure of data contained on this sheet is subject to the restriction on the title page of this white paper. 4
  7. 7. MMIS Solutions: A New Approach to Forming MMIS Project Teams October 2012associated with MMIS DDI projects, states that are preparing for an MMIS DDI project must ask thefollowing questions:1. Do we have the skills, experience, and expertise to adequately staff our MMIS DDI Project? If the answer is yes, great! If the answer is no…2. How do we obtain the skills, experience and expertise necessary to adequately staff our MMIS DDI Project?3. Is there an approach that reduces overall project risk and increases our chances for a successful MMIS DDI project?4. Do we have a team to match the MMIS vendor’s DDI project team and to meet the deliverables and timeframe established in the MMIS DDI contract?With the challenges states face in staffing MMIS DDI project teams and the current changing dynamics ofthe Medicaid environment, states should consider the following areas that represent a new and emergingapproach to building an experienced MMIS DDI Project Team.Develop an accurate staffing model. Often, underestimating staffing needs is one of the first significantmistakes made during the planning phase. States should accurately develop a staffing plan that positionsthem for success, free of state-imposed limitations that may add risk to the MMIS DDI project from theoutset. Include the costs to support the ideal project team in the MMIS DDI IAPD.Leverage qualified and available staff. States should assess their internal staff and determine whether ornot staff members with the skills and experience to do the job exist and are available. Even the very beststaff will have to overcome a steep learning curve for MMIS DDI projects.Fill key leadership positions. States should focus on finding a key leader within the organization who canassume the role of project director and provide overall project strategy and direction.Identify MMIS DDI project team gaps. States typically can fill certain project team positions more easily.Those that are more difficult to staff must be identified, as they represent gaps that must be filled.Procure MMIS DDI Project Team Services. Based on the team gap assessment, states should contract forqualified, experienced MMIS staff that brings expertise to the State Project Team.THE BENEFITS OF SUPPLEMENTING YOUR TEAMWhile the concept of contracting out for MMIS DDI project team support has been used before, it isgaining more momentum now. A number of states have contracted out for key MMIS DDI project teampositions and, more recently, states have released Requests for Proposals that expand this approach bycontracting out for the majority of MMIS DDI Project Team services, including key functional positions.The benefits of contracting out for MMIS DDI Project Team support include: Benefits of MMIS DDI Project Team Contracted SupportAccelerated Project Readiness A PM structure that is in place within four to six weeks, rather than three to four months, by avoiding lengthy and challenging state HR processes.MMIS Specific Tools Access to libraries of MMIS Project Management Plans and proven MMIS project& Templates tools and templates.Proven Project Management Advantage of Certified Project Management professional expertise and projectExpertise managers with MMIS DDI experience.Seasoned Senior Medicaid Medicaid consultants with strategic, policy expertise.Expertise Medicaid subject matter and MITA expertise. CMS guidance expertise, e.g., modular approach to ensure maximum Federal Financial Participation (FFP).Experienced MMIS IT professional expertise for your MMIS DDI Project Team. Use or disclosure of data contained on this sheet is subject to the restriction on the title page of this white paper. 5
  8. 8. MMIS Solutions: A New Approach to Forming MMIS Project Teams October 2012 Benefits of MMIS DDI Project Team Contracted SupportIT Professionals Ability to add SOA, EHR and HIT expertise to the MMIS DDI Project Team.Cost Neutral Ability to maximize value through 90% enhanced Federal Financial ParticipationApproach while minimizing the need for additional General Fund investment.Time and Materials Contract Provides the state with maximum contract flexibility. Provides a contract mechanism to increase or decrease MMIS Project Team support based on project need.Access to Talent Ability to phase in additional specialized talent when needed, i.e., during testing and certification. Exhibit 3. Benefits of MMIS DDI Project Team Contracted SupportMOVING AHEAD WITH YOUR MMIS DDI PROJECTStates in the planning stages of their MMIS DDI project should consider the approach that is best alignedwith their project needs and goals and consider the following:Develop your MMIS DDI project team strategy and seek input. Don’t work in a vacuum. The MMIS DDIproject team has a significant impact on the success of your project. Develop your strategy and seek inputfrom CMS, partner states and vendors. Outside feedback will help validate assumptions and will becomea valuable source of information.Implement your MMIS DDI project team strategy early. It is critical that you have your core MMIS DDIproject team in place as early as possible. Once the DDI project begins, the pace will be very fast and itwill be difficult to get maximum performance of project team members who are added mid project.Contracting out for MMIS DDI project team services and support should be done early. Just as it isimportant to fill key MMIS DDI project team roles with internal staff as early as possible, it’s just asimportant to begin the procurement process for MMIS DDI project team support as early as possible.Make sure that a procurement timeline is developed so that MMIS DDI project team support is on boardprior to, or as close as possible to, the DDI project start date.Use a contract vehicle that maximizes flexibility. An important consideration to contracting out for MMISDDI project team support is the type of contract that should be used. Historically, states have used firm-fixed-price contracts for managing the DDI vendor. While this works well for deliverable andimplementation contracts, it is less effective for service and support contracts. States should considerusing a Time and Materials (T&M) contract to procure MMIS DDI project team support services. Thisform of contract will provide the greater flexibility needed to effectively manage the MMIS DDI project.A T&M contract will allow the state to ramp up or scale back project support based on project need. AT&M contract also will allow the state to establish rates for specific personnel that may be needed on aperiodic basis, such as testing support.Reference recent or existing Requests for Proposals when developing your statement of work. States thatare considering this approach should look to other states that have used a similar approach and leveragelanguage and proposal sections that align best with your project goals and needs. Some states that havecontracted out for MMIS DDI project team support include Arkansas, Georgia, Iowa, Maryland, NewYork, Missouri, Oklahoma, Oregon and WisconsinCONTACT INFORMATIONBased on our more than 25 years of experience supporting state MMIS DDI projects, we offer theserecommendations as our assessment of the MMIS DDI project team – challenges to formation,composition and functional roles – and propose a new approach that mitigates project risk and ensuressuccess while complementing the existing organization’s talent pool. Contact us and we will share ourMMIS DDI project team staffing model, as well as our APD and budget templates with you. Use or disclosure of data contained on this sheet is subject to the restriction on the title page of this white paper. 6
  9. 9. MMIS Solutions: A New Approach to Forming MMIS Project Teams October 2012AuthorsJarred Clark Jim JoyceManaging Director Senior Vice President, MedicaidJarred.Clark@cognosante.com Jim.Joyce@cognosante.comCognosante Medicaid Management Services7926 Jones Branch Drive, Suite 330, McLean, VA 22102Phone (480) 423-8184 • Fax (480) 481-423-8108Cognosante has successfully served state Medicaid agencies for 25 years in the acquisition andimprovement of Medicaid Management Information Systems (MMIS). We are nationally recognized forour MMIS expertise and have a practice area dedicated exclusively to serving Medicaid agencies. Wehave worked closely with the Centers for Medicare & Medicaid Services (CMS) to develop, documentand continually implement best practices for the Medicaid Information Technology Architecture (MITA).We are currently providing technical support services for the design and development of an MMISCertification Manual that includes current MMIS certification review criteria, on-site review protocols foreach functional area being certified, and traceability regarding the source of the requirement.Cognosante provides project management and personnel support, procurement strategy and acquisitionassistance, Medicaid Information Technology Architecture (MITA) 3.0 assessments and transformationservices, MITA State Self-Assessments, State Medicaid Health Information Technology (HIT) Plan(SMHP) maintenance and support, and independent verification & validation (IV&V) and qualityassurance (QA) services. Cognosante has the knowledge and experience necessary to transform yourMedicaid practice. Contact us for assistance with your Medicaid needs.To learn more about Cognosante, please visit www.cognosante.com. Use or disclosure of data contained on this sheet is subject to the restriction on the title page of this white paper. 7

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