Commonwealth of Virginia
Puzzle: To clarify or solve (something confusing) by reasoning or study
David E. Mix, PMP, MBA
HIT/MITA Program Manager
Department of Medical Assistance Services
Commonwealth of Virginia
David.mix@dmas.virginia.gov
Puzzle Pieces
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American Recovery and Reinvestment Act (ARRA)
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Patient Protection and Affordable Care Act (PPACA)
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Health Benefit Exchange (HBE/HBX), Eligibility Systems, Medicaid expansion looking for better user
experience and coordination of services
DHHS efforts towards simplified enrollment standards and Federal verification service with IRS, DHS,
SSA
Enhanced funding for eligibility systems to support HBE/HBX
Other factors
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HITECH: Health Information Exchange (HIE), certified Electronic Health Record (EHR), Provider
Incentive Program, meaningful use looking for better outcomes and coordination of care
X12 5010/NCPDP D.0, ICD10, NCCI, Provider screening regulation
State mandates
State budget challenges
State assets (as-is)
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Executive support
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Multi-Secretariat collaboration championed by Dr. Bill Hazel, Secretary of Health and Human Services
Secretary of Technology, Jim Duffey and the Virginia IT Agency (VITA)
HIT Advisory Commission, Health Reform initiative, and HIT Standards Advisory Committee
Virginia Department of Motor Vehicles technology modernization efforts
State Agency legacy system silos
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Puzzle Picture
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To assemble a complex puzzle, a picture of
the completed puzzle is helpful
Medicaid IT Architecture (MITA) V2.0 Concept
of Operations (COO) document provides a
picture of the assembled puzzle
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Includes HIE, EHR, and eligibility systems (basis
for HBE/HBX)
While focus is on Medicaid/CHIP it does reflect
interoperability with other social service programs
Technology base is program agnostic
Business case: one of cost avoidance
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Virginia’s Strategy
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Leverage MITA as core strategy to address both ARRA and PPACA
requirements
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Adopt MITA vision (self-directed services)
Look at requirements from an enterprise perspective
Use MITA State Self Assessment process to align efforts to Federal direction
Maximize Federal funding assistance
Leverage Virginia’s existing assets
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VITA provides enterprise infrastructure
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Governance, standards, competency centers (new), hosting, disaster recovery,
strategic planning, help desk, cost allocation/rate setting, IT procurement/project
approval, project management
Strategic planning at Secretariat level with State Agency alignment begins
to reflect migration path to enterprise interoperability
Legacy systems can interoperate on the enterprise using standards-based
services/interfaces
Enterprise technical infrastructure becomes an enabler of business
transformation
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Work In Progress
Federal funding approved
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Establishing HIT/MITA program office
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Secretariat level
Fund and manage multiple HIT/MITA projects
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Data sharing/trust initiative
IT strategic planning initiative
Establishing a common physical technical architecture
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Compliant with MITA Technical Architecture Standard
Pay-for-use environment – available to all Federal/State/local programs
Foundation for HIE and HBE/HBX interoperability with State systems
Includes a Master Data Management (MDM) product for
person/organization information
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Targeting significant improvement to Medicaid enrollment accuracy
Establish Service Oriented Architecture (SOA) and MDM competency centers
Establish authentication service
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Tied to MDM product
Used for public facing portals (HIE & HBE/HBX etc)
Developed by Virginia Department of Motor Vehicles
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Planning In Progress
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Federal funding requested for interfacing
Health Department and State Lab systems to
the enterprise for access by HIE
Planning for replacement of multiple eligibility
systems with an integrated solution
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Reflected in MITA Transition Plan
Meets CMS seven conditions and standards for
funding
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References
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MITA
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Virginia MITA transition plan
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http://www.hits.virginia.gov/
Virginia State Medicaid HIT Plan
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http://dmasva.dmas.virginia.gov/Content_pgs/mita.aspx
Virginia HIE Strategic and Operations Plan
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http://www.cms.gov/MedicaidInfoTechArch/
http://dmasva.dmas.virginia.gov/Content_pgs/pr-arra.aspx
Virginia IT Agency (VITA) Enterprise standards
 http://www.vita.virginia.gov/oversight/dm/default.
aspx?id=10344
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