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Connecticut Health Insurance Exchange Information Technology Project Overview. April 19, 2012 Prepared by CTHIX Management Team. Agenda. HIX Major Processes Program Integration IT Phasing MOU Department of Social Services HIX Technical Assistances

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connecticut health insurance exchange information technology project overview

Connecticut Health Insurance ExchangeInformation Technology Project Overview

April 19, 2012

Prepared by CTHIX Management Team

agenda
Agenda
  • HIX Major Processes
  • Program Integration
  • IT Phasing
  • MOU Department of Social Services
  • HIX Technical Assistances
  • HIX Solution Request for Information
  • Questions and Answers
program integration without integrated eligibility

Individual Purchase

Medicaid

Subsidy

Other

Eligibility Determination

Eligibility Determination

Eligibility Determination

Eligibility Determination

Eligibility Determination

DDS

DSS

Exchange

DMHAS

DPH

DCF

Program Integration | Without Integrated Eligibility

Multiple

Front Doors

Multiple

Eligibility Platforms

Multiple

Eligibility Outcomes

Connecticut Health Insurance Exchange

Page

program integration integrated eligibility

Eligibility Determination

  • HIX
  • DSS
  • DDS
  • DCF
  • DMHAS
  • DPH

Single Front Door

Consumer Enters Info

Program Integration | Integrated Eligibility

One Eligibility Determination Process for All HHS Programs

Single Front Door

Unified

Eligibility Platform

Connecticut Health Insurance Exchange

Page

it phasing
Priority Track

IT plan emphasizes the priorities of HIX and Medicaid (CT DSS):

Exchange operations

MAGI and other eligibility

Other HHS

Strategy to achieve an integrated eligibility solution to serve all HHS agencies

Solution for HIX and DSS will become the core of an integrated eligibility platform

Phased implementation for HHS agencies will follow HIX and DSS roll out

IT Phasing
  • Now exploring phased implementations to facilitate key deadlines

2015

2012

2013

2014

Q3

Q4

Q1

Q2

Q3

Q4

JAN

FEB

MAR

APR

MAY

JUN

JUL

AUG

SEP

OCT

NOV

DEC

JAN

FEB

MAR

APR

MAY

JUN

JUL

AUG

SEP

OCT

NOV

DEC

Q1

Q2

Priority Track: HIX Operations, MAGI and other Eligibility

Go-Live New Eligibility Determination

Coverage

Begins

Go-Live deadline for enhanced FFP

Other HHS Integrated Eligibility & Non-Priority Modernization

it phasing1
IT Phasing
  • Revised Approach Currently Consolidating Planning & Implementation

Consolidated Approach

  • Planning, Design, Procurement coordinated across all Medicaid, HHS and HIX stakeholders
  • One Master Technical Assistance Contractor
  • Coordinate all CCIIO and CMS Gates & certifications
  • Developing expedited Procurement Strategy to accelerate Implementation and Collapse Time-to-Market
  • e.g. Leverage State’s List of Pre-Selected IT Firms
  • e.g. Potentially use Single Implementation Prime

HIX

MITA 3.0 Self-Assessment

Unified Agency Governance

Medicaid-only Eligibility,E-APD & Certifications

Consolidate Contractor/Procurement

TBD

Component Modernizations

Integrated Eligibility

TBD

Multiple

Other

mou department of social services
MOU| Department of Social Services

MOU Between HIX and DSS (Medicaid)

  • MOU between
  • HIX and DSS:
  • Coordinate Plan/Procure cycle
  • Share Technical Resources and Vendors
  • Coordinate Federal approvals and Certifications
  • Lays groundwork for shared Operations

HIX Development

Unified, Coordinated

CT Medicaid and HHS Modernizations

hix technical assistance
HIX Technical Assistance
  • Original Phasing of HIX Planning Basis of HIX Contractor SOW
  • Primarily HIX-focused
  • Soft Coordination with Medicaid Modernization

HIX Technical Assistance Contractor

Specifications

for Preferred Option

RFP Development &ProcurementSupport

PurchaseStrategyOptions& Prelim Cost Estimate

  • Business ProcessRequirements

Option Selection

  • IT Requirements

Implementation Plan

Concept of

Operations

hix operating options drive functional requirements and define exchange logical component model
HIX Operating Options Drive Functional Requirements and Define Exchange Logical Component Model

Exchange Operating Model ‘”Options”

IT Solution Implementation Options for Planning & Budgeting

Business Process

May support one or more

May be included in

Has one or more

Operating Model

Functional Requirement

Exchange Business Service

(Software)

Logical Component

Determines

Automates

May require

hix solution request for information
HIX Solution Request for Information
  • RFI issued March 9, 2012
    • Review options available in the market for information technology and business process solutions
    • 12 responses received March 30
    • Responses will be reviewed and evaluated during April