Figure 33: Operations Management Data Store Changes To-Be Kentucky Medicaid is planning to implement a new MEMS in the near future. This will, of course, affect the operations management area considerably due to the fact that these processes are implemented in that system. The biggest set of changes to Operations Management will be the addition of a business rules engine to provide more flexible editing of claims and encounters. Encounter processing will see stricter editing and will be used to manage the MCO contracts in a more automated way. 3.2.8 Performance Management Figure 34: Performance Management Business Area Performance Management Level Level Level Level Level Note(s) 1 2 3 4 5 Does the business area have governance As-Is To-Be OATS has developed a of data management? data governance body to promote data standards and integrity throughout the SMA, but activity is still in development and has not previously been focused on data governance from a MITA perspective. Standards vary Does the business area have common data As-Is To-Be across system, architecture? common contractor layout across KYMMIS. OATS relies on federal standards and details for contracted systems and can vary from project to project to manage data architecture. Standard
Figure 33: Operations Management Data Store Changes To-Be Kentucky Medicaid is planning to implement a new MEMS in the near future. This will, of course, affect the operations management area considerably due to the fact that these processes are implemented in that system. The biggest set of changes to Operations Management will be the addition of a business rules engine to provide more flexible editing of claims and encounters. Encounter processing will see stricter editing and will be used to manage the MCO contracts in a more automated way. 3.2.8 Performance Management Figure 34: Performance Management Business Area Performance Management Level 1 Level 2 Level 3 Level 4 Level 5 Note(s) Does the business area have governance of data management? As-Is To-Be OATS has developed a data governance body to promote data standards and integrity throughout the SMA, but activity is still in development and has not previously been focused on data governance from a MITA perspective. Does the business area have common data architecture? As-Is To-Be Standards vary across system, common contractor layout across KYMMIS. OATS relies on federal standards and details for contracted systems and can vary from project to project to manage data architecture. Standard