CENTERS for MEDICARE & MEDICAID SERVICES Information Technology Architecture CENTERS for MEDICARE &...

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CENTERS for MEDICARE & MEDICAID SERVICES Medicaid Information Technology Architecture February 10, 2003 1

Transcript of CENTERS for MEDICARE & MEDICAID SERVICES Information Technology Architecture CENTERS for MEDICARE &...

Page 1: CENTERS for MEDICARE & MEDICAID SERVICES Information Technology Architecture CENTERS for MEDICARE & MEDICAID SERVICES What Is the MITA Conceptual Architecture? What Is the MITA Conceptual

CENTERS for MEDICARE & MEDICAID SERVICES

Medicaid Information Technology Architecture

February 10, 2003

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Page 2: CENTERS for MEDICARE & MEDICAID SERVICES Information Technology Architecture CENTERS for MEDICARE & MEDICAID SERVICES What Is the MITA Conceptual Architecture? What Is the MITA Conceptual

Medicaid Information Technology Architecture

Medicaid Information Technology Architecture CENTERS for MEDICARE & MEDICAID SERVICES

Agenda Agenda

� Where We Are Today

� The Vision for the Future

� How We Plan to Translate the Vision Into Reality

� MITA Initiative

� The Conceptual Architecture

� The Approach

� What All This Means for States Over the Next 3 to 5 years

� Next Steps

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Page 3: CENTERS for MEDICARE & MEDICAID SERVICES Information Technology Architecture CENTERS for MEDICARE & MEDICAID SERVICES What Is the MITA Conceptual Architecture? What Is the MITA Conceptual

Where We Are Today

Medicaid Information Technology Architecture

Medicaid Information Technology Architecture CENTERS for MEDICARE & MEDICAID SERVICES

Where We Are Today

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MedicaidInformationTechnologyArchitecture

MedicaidInformationTechnologyArchitecture CENTERS for MEDICARE & MEDICAID SERVICES

Driving Forces/ChallengesDriving Forces/Challenges

“Blue Books” Claims

Recipient TPL

LegislativeMandates

CodeSets

UtilizationReview

ManagementReports

Recipient Provider

Claims

MMIS

Medicaid Program Changes

Rapid Changes in Technology

Resource Limitations “Blue Books”

MARSSURS

Reference

“Blue Books”Claims

Recipient Provider

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Medicaid Information Technology Architecture

Medicaid Information Technology Architecture CENTERS for MEDICARE & MEDICAID SERVICES

Web Analytics

Online Analytical Processing

(OLAP)

World Wide Web

Multidimensional Databases

Enterprise Information

Portals

Data Mining

Analytic Applications

MMIS Evolution and Trends— 1970 to Today

MMIS Evolution and Trends— 1970 to Today

Ad Hoc Query Tools

Data Warehouses

Relational Databases

Decision Support Systems (DSS)

Executive Information

Systems(EIS)

Transaction Systems

Extract Files

Financial Reporting Systems

Reporting Systems

(MARS +SURS)

1970 1985 1990 1995 Today

Source: modified from Data Warehousing and E-Commerce, William J. Lewis 5

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Vision for the FutureVision for the Future

Medicaid Information Technology Architecture

Medicaid Information Technology Architecture CENTERS for MEDICARE & MEDICAID SERVICES

Page 7: CENTERS for MEDICARE & MEDICAID SERVICES Information Technology Architecture CENTERS for MEDICARE & MEDICAID SERVICES What Is the MITA Conceptual Architecture? What Is the MITA Conceptual

Medicaid Information Technology Architecture

Medicaid Information Technology Architecture CENTERS for MEDICARE & MEDICAID SERVICES

Current Medicaid IT ArchitectureCurrent Medicaid IT Architecture

State Federal/CMS

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Data Warehouse

MMIS MSIS 1

2

3

1. Decision Support System 2. Immunization Registries 3. Eligibility Determination Systems

Page 8: CENTERS for MEDICARE & MEDICAID SERVICES Information Technology Architecture CENTERS for MEDICARE & MEDICAID SERVICES What Is the MITA Conceptual Architecture? What Is the MITA Conceptual

Medicaid Information Technology Architecture

Medicaid Information Technology Architecture CENTERS for MEDICARE & MEDICAID SERVICES

Federal/CMSState

Data Warehouse

Web-Based Interface

Web-Based Interface

MMIS

b

dc

e f

a

6

4

5MSIS

1

2

3

Planned Medicaid Systems ArchitecturePlanned Medicaid Systems Architecture

1. Decision Support System 2. Other Public Heath Data Sets 3. Eligibility Determination Systems

4. State Summary Data Reports 5. Annual Person Summary 6. Clinical Services Data Marts

Note: States will be able to access data marts directly and the granular database through CMS on request. 8

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MEDICARE

MEDICAID

1. 2. 3.

Medicare-Managed Care Data

System

Enrollment Database

Quality Net OSCARPaid Claims

History File

1

3

2MSIS

Future CMS Medicaid + Medicare IT Data Sharing

Future CMS Medicaid + Medicare IT Data Sharing

State Summary Data Reports Summary Annual Person

Clinical Services Data Marts

Medicaid Information Technology Architecture

Medicaid Information Technology Architecture CENTERS for MEDICARE & MEDICAID SERVICES

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Inter-Agency Data SharingInter-Agency Data Sharing

State Data Sets

Medicaid Information Technology Architecture

Medicaid Information Technology Architecture

CMS Data Sets

(both Medicaid and Medicare)

HRSACDC

State Data Sets

Medicaid Information Technology Architecture

Medicaid Information Technology Architecture CENTERS for MEDICARE & MEDICAID SERVICES

Medicaid Information Technology Architecture

Medicaid Information Technology Architecture

Page 11: CENTERS for MEDICARE & MEDICAID SERVICES Information Technology Architecture CENTERS for MEDICARE & MEDICAID SERVICES What Is the MITA Conceptual Architecture? What Is the MITA Conceptual

How We Plan To Translate The Vision

Medicaid Information Technology Architecture

Medicaid Information Technology Architecture CENTERS for MEDICARE & MEDICAID SERVICES

How We Plan To Translate The Vision

Into Reality Into Reality

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Page 12: CENTERS for MEDICARE & MEDICAID SERVICES Information Technology Architecture CENTERS for MEDICARE & MEDICAID SERVICES What Is the MITA Conceptual Architecture? What Is the MITA Conceptual

The MITA Initiative

Medicaid Information Technology Architecture

Medicaid Information Technology Architecture CENTERS for MEDICARE & MEDICAID SERVICES

The MITA Initiative

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Page 13: CENTERS for MEDICARE & MEDICAID SERVICES Information Technology Architecture CENTERS for MEDICARE & MEDICAID SERVICES What Is the MITA Conceptual Architecture? What Is the MITA Conceptual

Medicaid Information Technology Architecture

Medicaid Information Technology Architecture CENTERS for MEDICARE & MEDICAID SERVICES

The MITA InitiativeThe MITA Initiative

A national framework supporting improved systems development and health care management for

the Medicaid enterprise

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Page 14: CENTERS for MEDICARE & MEDICAID SERVICES Information Technology Architecture CENTERS for MEDICARE & MEDICAID SERVICES What Is the MITA Conceptual Architecture? What Is the MITA Conceptual

Medicaid Information Technology Architecture

Medicaid Information Technology Architecture CENTERS for MEDICARE & MEDICAID SERVICES

MITA Initiative Key Principles MITA Initiative Key Principles

� Data Sharing

� Reusable Components

� Modularity

� Open Architecture

� Standards

� Collaboration

� Security

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MITA InitiativeMITA Initiative

Support the Transition

Develop the Architectural Components

Establish the Framework

MITA

Medicaid Information Technology Architecture

Medicaid Information Technology Architecture CENTERS for MEDICARE & MEDICAID SERVICES

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MITA

MITA InitiativeMITA Initiative

� Strategic Plan

� Conceptual Architecture

� MITA Steering Committee

� MITA Technical Group

� Review Policies

� Methodology Guidelines

� Publicize and Market Establish the Framework

Medicaid Information Technology Architecture

Medicaid Information Technology Architecture CENTERS for MEDICARE & MEDICAID SERVICES

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MITA

MITA InitiativeMITA Initiative

� Common Requirements

� Implementation Standards

� Reusable Components

� Enterprise Process Model

� Enterprise Data Model

Develop the Architectural Components

Medicaid Information Technology Architecture

Medicaid Information Technology Architecture CENTERS for MEDICARE & MEDICAID SERVICES

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MITA

MITA InitiativeMITA Initiative

� Transition Plan Template

� Other Tools and Templates

� Education

Support the Transition

Medicaid Information Technology Architecture

Medicaid Information Technology Architecture CENTERS for MEDICARE & MEDICAID SERVICES

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The Conceptual ArchitectureThe Conceptual Architecture

Medicaid Information Technology Architecture

Medicaid Information Technology Architecture CENTERS for MEDICARE & MEDICAID SERVICES

Page 20: CENTERS for MEDICARE & MEDICAID SERVICES Information Technology Architecture CENTERS for MEDICARE & MEDICAID SERVICES What Is the MITA Conceptual Architecture? What Is the MITA Conceptual

Medicaid Information Technology Architecture

Medicaid Information Technology Architecture CENTERS for MEDICARE & MEDICAID SERVICES

Establish the Framework— Conceptual Architecture

Establish the Framework— Conceptual Architecture

The goal is to provide the states with a conceptual architecture which will serve as a framework for improved system development and data exchange within and among states, federal agencies, and other health care partners.

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Page 21: CENTERS for MEDICARE & MEDICAID SERVICES Information Technology Architecture CENTERS for MEDICARE & MEDICAID SERVICES What Is the MITA Conceptual Architecture? What Is the MITA Conceptual

Medicaid Information Technology Architecture

Medicaid Information Technology Architecture CENTERS for MEDICARE & MEDICAID SERVICES

What Is the MITA Conceptual Architecture?What Is the MITA Conceptual Architecture?

� MITA IS NOT: � MITA CAN BE

� Installable software (WITH YOUR HELP):

� Mandated requirements

� A single mold (one size does not fit all)

� Guidelines incorporating new technology

� Roadmap for implementation

� A model system � Consensus on what should be required when systems are replaced

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Page 22: CENTERS for MEDICARE & MEDICAID SERVICES Information Technology Architecture CENTERS for MEDICARE & MEDICAID SERVICES What Is the MITA Conceptual Architecture? What Is the MITA Conceptual

Medicaid Information Technology Architecture

Medicaid Information Technology Architecture CENTERS for MEDICARE & MEDICAID SERVICES

Key Principles—Making Them RealKey Principles—Making Them Real

� Standards

� Reusable components

� Multi-centric

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Conceptual Architecture—PastConceptual Architecture—Past

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Code Sets

Utilization Review

Management Reports

Recipient Provider

Claims

Medicaid Information Technology Architecture

Medicaid Information Technology Architecture CENTERS for MEDICARE & MEDICAID SERVICES

Page 24: CENTERS for MEDICARE & MEDICAID SERVICES Information Technology Architecture CENTERS for MEDICARE & MEDICAID SERVICES What Is the MITA Conceptual Architecture? What Is the MITA Conceptual

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Conceptual Architecture—PastConceptual Architecture—Past

TPL SURS Fraud Detect

Prior Authorization

Enrollment

Outsourced Functions

Web Portal

Data Ware-house

EVS AVRS

Rx POS

DD, DOA, DMH

Waivers

Other State

Agencies

State, Local Public Health

Eligibility Determin­

ation

SCHIP EPSDT NEDSS

IZ

CMS CDC

SAMHSA

DOF State Bank

Clearing-house

Managed Care

Contracts

Contracted Benefit

Management Drugs, Mental

HealthMMIS Subsystems

Medicaid Information Technology Architecture

Medicaid Information Technology Architecture CENTERS for MEDICARE & MEDICAID SERVICES

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Conceptual Architecture— Bridge to the Future

Conceptual Architecture— Bridge to the Future

TPL SURS Fraud Detect

DD, DOA, DMH

Waivers

Prior Authorization

Enrollment

Outsourced Functions

Other State

Agencies

State, Local Public Health

Eligibility Determin­

ation

SCHIP EPSDT NEDSS

IZ

CMS CDC

SAMHSA

DOF State Bank

Clearing-house

Managed Care

Contracts

Contracted Benefit

Management Drugs, Mental

Health

Web Portal

Data Ware-house

EVS AVRS

Rx POS

MMIS Subsystems

Medicaid Information Technology Architecture

Medicaid Information Technology Architecture CENTERS for MEDICARE & MEDICAID SERVICES

Page 26: CENTERS for MEDICARE & MEDICAID SERVICES Information Technology Architecture CENTERS for MEDICARE & MEDICAID SERVICES What Is the MITA Conceptual Architecture? What Is the MITA Conceptual

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MedicaidInformationTechnologyArchitecture

MedicaidInformationTechnologyArchitecture CENTERS for MEDICARE & MEDICAID SERVICES

OTHERAGENCIES

Conceptual Architecture—FutureConceptual Architecture—Future

TPLSURSFraudDetect

DD, DOA,DMH

Waivers

PriorAuthorization

Enrollment

OutsourcedFunctions

OtherState

Agencies

State,LocalPublicHealth

EligibilityDetermin-

ation

SCHIPEPSDTNEDSS

IZ

CMSCDC

SAMHSA

DOFStateBank

Clearing-house

ManagedCare

Contracts

ContractedBenefit

ManagementDrugs, Mental

Health

WebPortal

DataWare-house

EVSAVRS

RxPOS

MMISSubsystems

TPLSURSFraudDetect

DD, DOA,DMH

Waivers

PriorAuthorization

Enrollment

OutsourcedFunctions

OtherState

Agencies

State,LocalPublicHealth

EligibilityDetermin-

ation

SCHIPEPSDTNEDSS

IZ

CMSCDC

SAMHSA

DOFStateBank

Clearing-house

ManagedCare

Contracts

ContractedBenefit

ManagementDrugs, Mental

Health

WebPortal

DataWare-house

EVSAVRS

RxPOS

TPLSURSFraudDetect

DD, DOA,DMH

Waivers

PriorAuthorization

Enrollment

OutsourcedFunctions

OtherState

Agencies

State,LocalPublicHealth

EligibilityDetermin-

ation

SCHIPEPSDTNEDSS

IZ

CMSCDC

SAMHSA

DOFStateBank

Clearing-house

ManagedCare

Contracts

ContractedBenefit

ManagementDrugs, Mental

Health

WebPortal

DataWare-house

EVSAVRS

RxPOS

MMISSubsystems

State 1

OTHERSTAKEHOLDERS

WebPortal

DataWare-house

EVSAVRS

RxPOS

PriorAuthorization

Enrollment

EligibilityDetermin-

ation

MMISSubsystems

WebPortal

DataWare-house

EVSAVRS

RxPOS

PriorAuthorization

Enrollment

EligibilityDetermin-

ation

MMISSubsystems

State 3

TPLSURSFraudDetect

PriorAuthorization

Enrollment

OutsourcedFunctions

WebPortal

DataWare-house

EVSAVRS

RxPOS

EligibilityDetermin-

ation

SCHIPEPSDTNEDSS

IZ

CMSCDC

SAMHSA

MMISSubsystems

TPLSURSFraudDetect

PriorAuthorization

Enrollment

OutsourcedFunctions

WebPortal

DataWare-house

EVSAVRS

RxPOS

EligibilityDetermin-

ation

SCHIPEPSDTNEDSS

IZ

CMSCDC

SAMHSA

MMISSubsystems

State 2

DATA EXCHANGE

Access Policy

StandardsSecurity

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MITA

From Concept to ApproachFrom Concept to Approach

� What the Conceptual MITA will look like

� How we plan to build it

Medicaid Information Technology Architecture

Medicaid Information Technology Architecture CENTERS for MEDICARE & MEDICAID SERVICES

Page 28: CENTERS for MEDICARE & MEDICAID SERVICES Information Technology Architecture CENTERS for MEDICARE & MEDICAID SERVICES What Is the MITA Conceptual Architecture? What Is the MITA Conceptual

The Approach

Medicaid Information Technology Architecture

Medicaid Information Technology Architecture CENTERS for MEDICARE & MEDICAID SERVICES

The Approach

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Page 29: CENTERS for MEDICARE & MEDICAID SERVICES Information Technology Architecture CENTERS for MEDICARE & MEDICAID SERVICES What Is the MITA Conceptual Architecture? What Is the MITA Conceptual

Medicaid Information Technology Architecture

Medicaid Information Technology Architecture CENTERS for MEDICARE & MEDICAID SERVICES

Conceptual Architecture—ApproachConceptual Architecture—Approach

� Build Partnerships

� Leverage Work Done to Date

� MITA Project Process � Data Collection

� Analysis and Design

� Validation

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Page 30: CENTERS for MEDICARE & MEDICAID SERVICES Information Technology Architecture CENTERS for MEDICARE & MEDICAID SERVICES What Is the MITA Conceptual Architecture? What Is the MITA Conceptual

Medicaid Information Technology Architecture

Medicaid Information Technology Architecture CENTERS for MEDICARE & MEDICAID SERVICES

Conceptual Architecture ApproachConceptual Architecture Approach

Steering Committee

MTG

CMS CO/RO

States

S-TAG

PS-TG

Other Industry Leaders

Other Federal

Agencies

Standards Setting Orgs

MITA Team

Public Health Survey

Others

S-TAGMMIS Redesign

Workgroups

PS-TG Papers

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Page 31: CENTERS for MEDICARE & MEDICAID SERVICES Information Technology Architecture CENTERS for MEDICARE & MEDICAID SERVICES What Is the MITA Conceptual Architecture? What Is the MITA Conceptual

Medicaid Information Technology Architecture

Medicaid Information Technology Architecture CENTERS for MEDICARE & MEDICAID SERVICES

Conceptual Architecture— The Process

Conceptual Architecture— The Process

Data Collection

Analysis and Design

Validation

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Develop Business Cases and

Sequencing Plan

Sequencing Plan and

Transition Strategy

Projects

Business Cases

Develop Target Information Systems

Architecture

Data Architecture

Application Architecture

Technology Architecture

Develop Target Business

Architecture

Organizational Structure and

Roles

Business Processes

Facility Locations

Document Mission, Vision, Strategy,

Current Architecture

Mission Programmatic Requirements

Current Architecture

Vision, Strategy

Page 32: CENTERS for MEDICARE & MEDICAID SERVICES Information Technology Architecture CENTERS for MEDICARE & MEDICAID SERVICES What Is the MITA Conceptual Architecture? What Is the MITA Conceptual

Medicaid Information Technology Architecture

Medicaid Information Technology Architecture CENTERS for MEDICARE & MEDICAID SERVICES

Data Collection Data Collection

Conceptual Architecture— The Process

Conceptual Architecture— The Process

Analysis and Design

Validation

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Page 33: CENTERS for MEDICARE & MEDICAID SERVICES Information Technology Architecture CENTERS for MEDICARE & MEDICAID SERVICES What Is the MITA Conceptual Architecture? What Is the MITA Conceptual

What All This Means for States and CMS Over the

Medicaid Information Technology Architecture

Medicaid Information Technology Architecture CENTERS for MEDICARE & MEDICAID SERVICES

What All This Means for States and CMS Over the

Next 3 to 5 Years Next 3 to 5 Years

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Page 34: CENTERS for MEDICARE & MEDICAID SERVICES Information Technology Architecture CENTERS for MEDICARE & MEDICAID SERVICES What Is the MITA Conceptual Architecture? What Is the MITA Conceptual

Medicaid Information Technology Architecture

Medicaid Information Technology Architecture CENTERS for MEDICARE & MEDICAID SERVICES

Why Is the MITA Initiative So Important? Why Is the MITA Initiative So Important?

MITA will enable:

� Improved managing and monitoring of programs through the sharing of data

� Efficient use of scarce resources through the development and sharing of reusable software

� Quick response to changes in programs

� Greater access to high-quality data

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Page 35: CENTERS for MEDICARE & MEDICAID SERVICES Information Technology Architecture CENTERS for MEDICARE & MEDICAID SERVICES What Is the MITA Conceptual Architecture? What Is the MITA Conceptual

Medicaid Information Technology Architecture

Medicaid Information Technology Architecture CENTERS for MEDICARE & MEDICAID SERVICES

Why Now?Why Now?

� No better time than now to improve our systems and realize the benefits of improved effectiveness and efficiency

� Wait too long and the cost of deferred modernization becomes so steep that catch-up is unaffordable

� Great strides have been made in data standardization—we can benefit NOW

� Achieve a significant return on our investment TODAY

� MITA can make the business case to CMSO senior leadership about how we can redefine the MMIS boundaries and create appropriate financial incentives to support the vision

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Page 36: CENTERS for MEDICARE & MEDICAID SERVICES Information Technology Architecture CENTERS for MEDICARE & MEDICAID SERVICES What Is the MITA Conceptual Architecture? What Is the MITA Conceptual

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We Need Your HelpWe Need Your Help Sunday Monday Tuesday Wednesday Thursday

MITA Focus Group: Industry Visioning

Session

Bridge to the New Architecture

MITA Room (Cabildo C)—QuestionnaireMITA Room (Cabildo C)—Questionnaire

Lunch Break

MITA Meeting with S-TAG, NMEH, and

PS-TG Members

NEDSS and the Medicaid IT

Architecture – Complimentary

Initiatives

MITA Overview

MITA Focus Group: State Visioning

Session

Report of Visioning Session Results

Medicaid Information Technology Architecture

Medicaid Information Technology Architecture CENTERS for MEDICARE & MEDICAID SERVICES

Page 37: CENTERS for MEDICARE & MEDICAID SERVICES Information Technology Architecture CENTERS for MEDICARE & MEDICAID SERVICES What Is the MITA Conceptual Architecture? What Is the MITA Conceptual

MITA is a journey, not a destination.

Medicaid Information Technology Architecture

Medicaid Information Technology Architecture CENTERS for MEDICARE & MEDICAID SERVICES

MITA is a journey, not a destination.

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Page 38: CENTERS for MEDICARE & MEDICAID SERVICES Information Technology Architecture CENTERS for MEDICARE & MEDICAID SERVICES What Is the MITA Conceptual Architecture? What Is the MITA Conceptual

Medicaid Information Technology Architecture

Medicaid Information Technology Architecture CENTERS for MEDICARE & MEDICAID SERVICES

MITA

Share the Vision

Chart the Course

Shape the Future

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Page 39: CENTERS for MEDICARE & MEDICAID SERVICES Information Technology Architecture CENTERS for MEDICARE & MEDICAID SERVICES What Is the MITA Conceptual Architecture? What Is the MITA Conceptual

Medicaid Information Technology Architecture

Medicaid Information Technology Architecture CENTERS for MEDICARE & MEDICAID SERVICES

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