To-Be Kentucky Process Narrative: Add the ability to do targeted enhanced selection. Identify sample selection using enhanced sampling methodology. Retrieve sample selection data. Prepare the Explanation of Benefits and/or notification letters. Format data into the required data set. End: Send data to the Send Outbound Transaction for generation. Send data to Manage Applicant and Member Communication for tracking purposes. Prepare REOMB AS-IS TO-BE Note(s) Assessment Assessment Capability Question Is the process primarily manual or automatic? 3 3 Constraint: No planned enhancements. Constraint: No Does the State Medicaid Agency use standards 3 3 planned in the process? enhancements. If sampling is used, what sampling algorithm is 1 2 used? Constraint: No Is communication linguistically, culturally, and 2 2 planned competency appropriate? enhancements. How does the State Medicaid Agency 2 3 collaborate with other agencies or entities in performing the process? How timely is this end-to-end process? 3 3 Constraint: No planned enhancements. How accurate is the information in the 2 3 process? What is the cost to perform the process 2 3 compared to the benefits of the results? How efficient is the process? 2 3 How accurate are the results of the process? 2 3 Does the business process satisfy 2 3 stakeholders? Business Process Assessment 1 2 Table 81: Prepare REOMB Business Process 2.2.9 Plan Management (PL) The Plan Management business area includes the strategic planning, policymaking, monitoring, and oversight business processes of the agency. This business area is responsible for the primary data stores (e.g., Medicaid State Plan, health plans and health benefits) as well as performance measures, reference
To-Be Kentucky Process Narrative: Add the ability to do targeted enhanced selection. Identify sample selection using enhanced sampling methodology. Retrieve sample selection data. Prepare the Explanation of Benefits and/or notification letters. Format data into the required data set. End: Send data to the Send Outbound Transaction for generation. Send data to Manage Applicant and Member Communication for tracking purposes. Prepare REOMB AS-IS Assessment TO-BE Assessment Note(s) Capability Question Is the process primarily manual or automatic? 3 3 Constraint: No planned enhancements. Does the State Medicaid Agency use standards in the process? 3 3 Constraint: No planned enhancements. If sampling is used, what sampling algorithm is used? 1 2 Is communication linguistically, culturally, and competency appropriate? 2 2 Constraint: No planned enhancements. How does the State Medicaid Agency collaborate with other agencies or entities in performing the process? 2 3 How timely is this end-to-end process? 3 3 Constraint: No planned enhancements. How accurate is the information in the process? 2 3 What is the cost to perform the process compared to the benefits of the results? 2 3 How efficient is the process? 2 3 How accurate are the results of the process? 2 3 Does the business process satisfy stakeholders? 2 3 Business Process Assessment 1 2 Table 81: Prepare REOMB Business Process 2.2.9 Plan Management (PL) The Plan Management business area includes the strategic planning, policymaking, monitoring, and oversight business processes of the agency. This business area is responsible for the primary data stores (e.g., Medicaid State Plan, health plans and health benefits) as well as performance measures, reference