As mentioned in my previous blog post, the MITA Framework Version 3.0 expanded on the definition of the State Self-Assessment or SS-A. The new and improved SS-A required a significant amount of work. State Medicaid Agencies were required to compare their business operations to the MITA business process model, identify systems and how they support the business, and how data is shared and managed. On paper, this does not sound very difficult. But if you think about how complex a State Medicaid Enterprise can be, it is a daunting task.

My first experience with the SS-A was in a project management role. The state that I worked with procured a vendor to complete their SS-A and I helped manage the vendor. The selected vendor had experience conducting SS-As in multiple states, so it was a great opportunity for me to learn more about how the process worked. The project required more than 100 state staff and it took more than one year to complete. By the time the SS-A was done, MITA was a forbidden term in the state! In addition to the excessive state resources and time commitment, the SS-A was also expensive, costing the state more than $1 million to pay for the vendor.

So, after the countless staff hours and money spent, what was the state left with? The state received a 500+ page document that regurgitated sections of the MITA Framework, contained inaccurate information about the state’s systems, people and processes, and recommendations for improvement that were of little value to the state. I would not say that the project was a failure; the vendor delivered exactly what they were contractually obligated to deliver. However, the state was left with a massive amount of documentation and they had no idea what to do with it or what it meant.

Unfortunately, this state was not alone. Many states performed their SS-As just because CMS suggested they do so. But very few states performed an SS-A with the intent of using the results to better understand their operations, to help with strategic planning, and to use it as a tool to measure their progress towards the future. After my initial SS-A project, I knew there had to be a better way to help states not only perform the SS-A, but to also find meaningful use for the results.