Produce Solicitation

Contract Management

Description

The Produce Solicitation business process gathers requirements, develops a solicitation (e.g., Request for Information (RFI), Request for Quotation (RFQ), or Request for Proposals (RFP)), receives approvals for the solicitation, and releases for response.

Business Process Template

Trigger events

Environment-based

A scheduled date for re-procurement of contract is due.
Request by Executive Management to procure or re-procure a contract.

Interaction-based

None published

Results

The State Medicaid Agency (SMA) produces an Advance Planning Document (APD).
The SMA produces a solicitation for distribution.
Tracking information as needed for measuring performance and business activity monitoring.

Business process steps

1. START: Receive directive to procure or re-procure contract.
2. Gather requirements for services.
3. Determine if CMS requires an APD. a. Produce APD. b. Modify APD as directed. c. Receive approval for APD.
4. Develop solicitation for the services.
5. Receive internal (state) and federal approvals for solicitation.
6. Advertise solicitation.
7. END: The SMA releases solicitation for response.

Predecessor processes

Manage Health Plan Information

Successor processes

Award Contract

Shared data

Plan data store including policy information
Health Benefit data store including benefit package and benefit information
Contractor data store including provider network
Manage Performance Measures data store including agency objectives and business activity
Information Technology (IT) Plan

Constraints

Each state decides what types of contracts to procure. States engage in a wide range of contracts. Statutes that provide the legal framework for procurements govern all States. Each state’s statutes are different from all other States. Business process steps differ from state to state.

Failures

The SMA loses funding for the procurement.
Insufficient responses to solicitation.

Performance measures

Time to complete process = ___ months; ___ weeks
Accuracy of information = ___ %
Accessibility of information for creating solicitation = ___ months; ___ weeks
Consistency of decisions and disposition = ___ %
Error rate = __% or less

Source: CMS MITA 3.0 Business Process Template, Contractor Management BPT.pdf, pages 11-12.

Business Capability Model (12 questions)

Each capability question defines five maturity levels, from Level 1 through Level 5.

Business Capability Descriptions

How integrated or central is the process?

LEVEL 1The process is re-invented each time a solicitation is necessary. SMA stores the procurement information for manual reuse, and it is not possible to share information.
LEVEL 2Contract information is in a central location and is electronic. There is coordination between agencies. Requirements tracking and maintenance are central.
LEVEL 3SMA centralizes and automates contract information. Coordination between agencies eliminates duplication of contracted services.
LEVEL 4SMA adopts MITA Framework, industry standards, and other national standards by interstate agencies and entities allow for shared business services.
LEVEL 5SMA adopts MITA Framework, industry standards, and other national standards by national agencies and entities allow for shared business services.

Is the process primarily manual or automatic?

LEVEL 1The process consists primarily of manual activity to accomplish tasks. Production of a solicitation consists primarily of manual, paper-based steps. This requires manual compilation of information.
LEVEL 2SMA uses a mix of manual and automatic processes to accomplish tasks. SMA coordinates between agencies electronic contract information from central location. Manual compilation of information remains a requirement in some cases. Publication of the solicitation uses electronic media (e.g., Web portal).
LEVEL 3SMA automates process to the full extent possible within the intrastate. SMA automates contract information from central location.
LEVEL 4SMA automates process to the full extent possible across the interstate.
LEVEL 5SMA automates process to the full extent possible across the nation.

What is the primary mechanism for publication of the solicitation and communication with potential respondents?

LEVEL 1Publication of the solicitation and communication with potential respondents is primarily via paper, in person, mail and facsimile. Publication of the solicitation may be via electronic media. Potential respondents can use telephone, facsimile, in person, e-mail, or paper as a way to keep current on any updates during the produce solicitation process.
LEVEL 2SMA centralizes contract information, and there is coordination between agencies. SMA automates the publication of the solicitation and communication concerning updates and solicitation status with potential respondents.
LEVEL 3SMA automates the process. Some in person communication remains a part of the process.
LEVEL 4SMA automates process to the full extent possible across the interstate.
LEVEL 5SMA automates process to the full extent possible across the nation.

Does the State Medicaid Agency use standards in the process?

LEVEL 1SMA focuses on meeting compliance thresholds for state and federal regulations using state-specific standards.
LEVEL 2SMA applies a mix of nationally recognized and state-specific standards.
LEVEL 3SMA adopts MITA Framework, industry standards, and other nationally recognized standards for intrastate exchange of information.
LEVEL 4SMA adopts MITA Framework, industry standards, and other nationally recognized standards for clinical and interstate information exchange.
LEVEL 5SMA adopts MITA Framework, industry standards, and other nationally recognized standards for national exchange of information.

How does the State Medicaid Agency collaborate with other agencies or entities in performing the process?

LEVEL 1Very little collaboration occurs with other agencies to standardize information exchange or business tasks.
LEVEL 2SMA collaborates with other agencies and entities to adopt nationally recognized standards and Electronic Data Interchange (EDI) transactions.
LEVEL 3SMA collaborates with other intrastate agencies and entities to adopt national standards, and to develop and share reusable business services.
LEVEL 4SMA collaborates with other interstate agencies and entities to adopt national standards, and to develop and share reusable processes including clinical information.
LEVEL 5SMA collaborates with agencies and entities for national (and international) interoperability improvements that maximize automation of routine operations.

Business Capability Quality: Timeliness of Process

How timely is the end-to-end process?

LEVEL 1Process meets threshold or mandated requirements for timeliness (i.e., the process achieves results within the time specified by law or regulation). The process may require six (6) or more months to issue the solicitation
LEVEL 2Process timeliness improves through use of automation. SMA uses web portals, email distribution and tracking, for respondent communications. Timeliness exceeds legal requirements. The process completes, on average, in six (6) months or less.
LEVEL 3Timeliness improves via state and federal collaboration, use of information sharing, standards, and regional information exchange hubs. The process supports outcome oriented program management, ensures MITA compliance, and supports the shift to shared business services in both the production of solicitations and their content. The process on average requires less than three (3) months for completion.
LEVEL 4Information is available in near real time. SMA has interstate interoperability. The process on average requires fewer than 60 business days to complete.
LEVEL 5Information is available in real time. Processes improve further through connectivity with other States and with federal agencies. Most processes execute at the point of service. Results are almost immediate.

Business Capability Quality: Data Access and Accuracy

How accurate is the information available to the process?

LEVEL 1Use of direct data entry for information collection is manually intensive and susceptible to inconsistent or incorrect information. Stakeholders are unable to rely on information for decision-making.
LEVEL 2Nationally recognized and state-specific standards improve accuracy of information but the decision-making process may be erroneous or misleading. Accuracy is higher than at Level 1.
LEVEL 3Automation of information collection increases the reliability of SMA’s internal information. External sources of information use MITA Framework and industry standards for information exchange. Decision-making is automatic using standardized business rules definitions. Accuracy rating is at 99% or higher.
LEVEL 4Automation of information collection increases the reliability of SMA’s internal and external sources of information. SMA adopts MITA Framework and industry standards for information exchange with interstate agencies. Decision-making is automatic using regional standardized business rules definitions. Accuracy rating is at 99% or higher.
LEVEL 5SMA adopts MITA Framework and industry standards for information exchange with national agencies. Decision-making is automatic using national standardized business rules definitions. Accuracy rating is at 99% or higher.

How accessible is the information in the process?

LEVEL 1SMA stores information in disparate systems including paper storage and obtains information manually. There is limited access to information by constraints of the manual process and updates to information. Accessing information to research and compile solicitation content can take more than six (6) months.
LEVEL 2SMA stores information in disparate systems, but automation and nationally recognized and state-specific standards increase accessibility over Level 1. Accessing information to research and compile solicitation content, on average, takes less than three (3) months.
LEVEL 3SMA obtains information easily and exchanges with intrastate agencies and entities based on MITA Framework and industry standards. SMA has enhanced the process support outcome-oriented program management and support the shift to shared business services in both the production of solicitations and their content. SMA can research exceptions through real-time access to information via industry messages. Access to information to research and compile solicitation content takes less than one (1) month.
LEVEL 4SMA obtains information easily and exchanges with interstate agencies and entities. Accessing information to research and compile solicitation content takes less than three (3) weeks.
LEVEL 5SMA obtains information easily and exchanges with national agencies and entities. Accessing information to research/compile solicitation content takes less than three (3) weeks.

Business Capability Quality: Cost Effectiveness

What is the cost of the process compared to the benefits of its results?

LEVEL 1High relative cost due to low number of automatic, standardized tasks.
LEVEL 2Automation improves process and allows focus on exception resolution. Adoption of solicitation tools to manage requirements. Increases cost effectiveness ratio over Level 1.
LEVEL 3SMA adopts MITA Framework, industry standards, and other nationally recognized standards. SMA enhances process to support improvements in program management, and support the shift to shared business services in both the production of solicitations and their content. The primarily automatic, standardized process allows staff to focus on managing the production of solicitations and effectively communicating with potential respondents. Increases cost effectiveness ratio over Level 2.
LEVEL 4SMA adopts MITA Framework, industry standards, and other nationally recognized standards for interstate information exchange. SMA increases cost effectiveness ratio over Level 3.
LEVEL 5SMA adopts MITA Framework, industry standards, and other nationally recognized standards for national (and international) information exchange. SMA increases cost effectiveness ratio over level 4.

Business Capability Quality: Effort to Perform; Efficiency

How efficient is the process?

LEVEL 1Process is labor intensive. There is wasted effort or expense to accomplish tasks. Process meets minimum state process guidelines and SMA performance standards. Efficiency is low.
LEVEL 2Automation and state standards increase productivity. Efficiency is higher than Level 1.
LEVEL 3SMA adopts MITA Framework, industry standards and information exchange with intrastate agencies and entities improving efficiency to 95% or higher.
LEVEL 4SMA adopts MITA Framework, industry standards and information exchange with interstate agencies and entities improving efficiency to 98% or higher.
LEVEL 5SMA adopts MITA Framework, industry standards and information exchange with national agencies and entities improving efficiency to 98% or higher.

Business Capability Quality: Accuracy of Process Results

How accurate are the results of the process?

LEVEL 1Manual processes result in greater opportunity for human error. Inconsistencies and ambiguities increase the number of respondent questions and can lead to post award protests. Accuracy is low.
LEVEL 2SMA centralizes automation and standardized business rules definitions reduce error. SMA centralizes and coordinates contract information between agencies. The development of Medicaid specific policies and procedures for the process reduces confusion and provides accurate information within the solicitation. Accuracy improves above Level 1.
LEVEL 3SMA adopts MITA Framework, industry standards and information exchange with intrastate agencies and entities. SMA enhances the process to support improved program management, and support the shift to shared business services in both the production of solicitations and their content. Accuracy is improved to 90% or higher.
LEVEL 4SMA adopts MITA Framework, industry standards and information exchange with interstate agencies and entities improving accuracy to 98% or higher.
LEVEL 5SMA adopts MITA Framework, industry standards and information exchange with national agencies and entities improving accuracy to 98% or higher.

Business Capability Quality: Utility or Value to Stakeholders

Does the business process satisfy stakeholders?

LEVEL 1Stakeholders lack confidence in information negatively affecting stakeholder satisfaction with the process.
LEVEL 2Automation and standardization provides clear and useful information. Stakeholder satisfaction is greater than Level 1.
LEVEL 3SMA adopts MITA Framework, industry standards and information exchange with intrastate agencies and entities improving stakeholder satisfaction to 90% or higher. SMA uses survey or questionnaire for information collection.
LEVEL 4SMA adopts MITA Framework, industry standards and information exchange with interstate agencies and entities improving stakeholder satisfaction to 95% or higher.
LEVEL 5SMA adopts MITA Framework, industry standards and information exchange with national agencies and entities improving stakeholder satisfaction to 98% or higher.

Source: CMS MITA 3.0 Business Capability Model, Contractor Management BCM.pdf, pages 36-45.

Other Contractor Management processes

Award Contract Close Out Contract Inquire Contractor Information Manage Contract Manage Contractor Communication Manage Contractor Grievance and Appeal Manage Contractor Information Perform Contractor Outreach