| | Exhibit 300 (BY2009) - Centers for Medicare and Medicaid Services CMS, Health Care Quality Improvement (Formerly QIES)PART ONE
OVERVIEW
- 1. Date of Submission:
- 2008-02-04
- 2. Agency:
- 009
- 3. Bureau:
- 38
- 4. Name of this Capital Asset:
- CMS Health Care Quality Improvement (Formerly QIES)
- 5. Unique Project Identifier:
- 009-38-01-02-01-1010-00
- 6. What kind of investment will this be in FY2009?
- Operations and Maintenance
- 7. What was the first budget year this investment was submitted to OMB?
- FY2001 or earlier
- 8. Provide a brief summary and justification for this investment, including a brief description of how this closes in part or in whole an identified agency performance gap.
- In the "Control" phase of the CPIC, the Health Care Quality Improvement System (HCQI) is the culmination of many years of work on oversight and information mechanisms that monitor and report on the quality and effectiveness of care and services provided to Medicare and Medicaid beneficiaries. The HCQI project meets the needs of State Survey Agencies, CMS, other Federal Agencies, Quality Improvement Organizations (QIO), beneficiaries, consumers and researchers that use information about the quality of care from Medicare and Medicaid providers. HCQI serves as the focal point for resident assessment, quality indicators, survey/certification, and enforcement information concerning providers. Furthermore, HCQI enables CMS' Center for Medicare Management and CMS' Fiscal Intermediaries to review resident assessment data against nursing homes, Home Health Agency (HHA), and Inpatient Rehabilitation Facility claims for which the payment is based on resource utilization groups. HCQI maintains important information on Federal oversight surveys (FMS and FOSS), enforcement data, and supports the Administrator's Nursing Home and Hospital initiatives. HCQI is the key source of quality data for CMS. HCQI consolidated disparate provider data collection activities into a single system. This system allows information to be shared quickly and conveniently between federal and state governments. It minimizes redundant data collection. It allows federal and state governments to access data from one central location. It collects provider and beneficiary specific outcomes of care and performance data from a multitude of delivery sites, and across multiple provider types (e.g., nursing homes, HHAs, ESRD, Rehabiliation Facilities (IRF-PAI), Swing-beds, Psychiatric hospitals). HCQI data are used to improve the quality and cost effectiveness of services provided by the Medicare and Medicaid programs and enables consumers to make educated choices about providers of care. HCQI operates on the the Quality Net (QNet). QNet is a network environment that uses shared database servers and WAN/LAN resources to monitor and improve utilization and quality of care for Medicare and Medicaid beneficiaries.
- 9. Did the Agency's Executive/Investment Committee approve this request?
- yes
- 9.a. If "yes," what was the date of this approval?
- 2007-06-26
- 10. Did the Project Manager review this Exhibit?
- yes
- 11.a. What is the current FAC-P/PM certification level of the project/program manager?
- TBD
- 12. Has the agency developed and/or promoted cost effective, energy-efficient and environmentally sustainable techniques or practices for this project.
- no
- 12.a. Will this investment include electronic assets (including computers)?
- yes
- 12.b. Is this investment for new construction or major retrofit of a Federal building or facility? (answer applicable to non-IT assets only)
- no
- 13. Does this investment directly support one of the PMA initiatives?
- yes
- If yes, select the initiatives that apply:
Initiative Name |
---|
Eliminating Improper Payments | Expanded E-Government |
- 13.a. Briefly and specifically describe for each selected how this asset directly supports the identified initiative(s)? (e.g. If E-Gov is selected, is it an approved shared service provider or the managing partner?)
- HCQI supports E-government by improving information technology management, simplifying business processes and unifying information flows. HCQI directly supports the delivery of high quality customer services and making government more transparent and accountable. It eliminates improper payments through implementing the enforcement provisions for nursing homes which include Civil Money Penalties and denial of payments for nursing homes who fail to meet CMS requirements.
- 14. Does this investment support a program assessed using the Program Assessment Rating Tool (PART)?
- yes
- 14.a. If yes, does this investment address a weakness found during the PART review?
- yes
- 14.b. If yes, what is the name of the PARTed program?
- 2003: CMS - Medicare Program
- 14.c. If yes, what rating did the PART receive?
- Moderately Effective
- 15. Is this investment for information technology?
- yes
- 16. What is the level of the IT Project (per CIO Council's PM Guidance)?
- Level 2
- 17. What project management qualifications does the Project Manager have? (per CIO Council's PM Guidance)
- (1) Project manager has been validated as qualified for this investment
- 18. Is this investment identified as high risk on the Q4 - FY 2007 agency high risk report (per OMB memorandum M-05-23)?
- no
- 19. Is this a financial management system?
- no
- 20. What is the percentage breakout for the total FY2009 funding request for the following? (This should total 100%)
Area | Percentage |
---|
Hardware | 0 | Software | 18 | Services | 71 | Other | 11 |
- 21. If this project produces information dissemination products for the public, are these products published to the Internet in conformance with OMB Memorandum 05-04 and included in your agency inventory, schedules and priorities?
- yes
- 22. Contact information of individual responsible for privacy related questions.
Name | Maribel Franey | Phone Number | 410-786-0757 | Title | Director, Privacy compliance | Email | Maribel.Franey@cms.hhs.gov |
- 23. Are the records produced by this investment appropriately scheduled with the National Archives and Records Administration's approval?
- yes
- 24. Does this investment directly support one of the GAO High Risk Areas?
- yes
SUMMARY OF SPEND
- 1. Provide the total estimated life-cycle cost for this investment by completing the following table. All amounts represent budget authority in millions, and are rounded to three decimal places. Federal personnel costs should be included only in the row designated Government FTE Cost, and should be excluded from the amounts shown for Planning, Full Acquisition, and Operation/Maintenance. The total estimated annual cost of the investment is the sum of costs for Planning, Full Acquisition, and Operation/Maintenance. For Federal buildings and facilities, life-cycle costs should include long term energy, environmental, decommissioning, and/or restoration costs. The costs associated with the entire life-cycle of the investment should be included in this report.
All amounts represent Budget Authority
Note: For the cross-agency investments, this table should include all funding (both managing partner and partner agencies).
Government FTE Costs should not be included as part of the TOTAL represented. Cost Type | Py-1 & Earlier -2006 | PY 2007 | CY 2008 | BY 2009 |
---|
Planning Budgetary Resources | 0.000 | 0.000 | 0.000 | 0.000 | Acquisition Budgetary Resources | 56.500 | 0.000 | 0.000 | 0.000 | Maintenance Budgetary Resources | 70.158 | 16.901 | 17.579 | 18.003 | Government FTE Cost | 0.386 | 0.257 | 0.219 | 0.219 | # of FTEs | 3 | 2 | 2 | 2 |
- 2. Will this project require the agency to hire additional FTE's?
- no
- 3. If the summary of spending has changed from the FY2008 President's budget request, briefly explain those changes.
- No
PERFORMANCE In order to successfully address this area of the exhibit 300, performance goals must be provided for the agency and be linked to the annual performance plan. The investment must discuss the agency's mission and strategic goals, and performance measures (indicators) must be provided. These goals need to map to the gap in the agency's strategic goals and objectives this investment is designed to fill. They are the internal and external performance benefits this investment is expected to deliver to the agency (e.g., improve efficiency by 60 percent, increase citizen participation by 300 percent a year to achieve an overall citizen participation rate of 75 percent by FY 2xxx, etc.). The goals must be clearly measurable investment outcomes, and if applicable, investment outputs. They do not include the completion date of the module, milestones, or investment, or general goals, such as, significant, better, improved that do not have a quantitative measure.
- Agencies must use the following table to report performance goals and measures for the major investment and use the Federal Enterprise Architecture (FEA) Performance Reference Model (PRM). Map all Measurement Indicators to the corresponding Measurement Area and Measurement Grouping identified in the PRM. There should be at least one Measurement Indicator for each of the four different Measurement Areas (for each fiscal year). The PRM is available at www.egov.gov. The table can be extended to include performance measures for years beyond FY 2009.
Row | Fiscal Year | Strategic Goal Supported | Measurement Area | Measurement Grouping | Measurement Indicator | Baseline | Planned Improvement to the Baseline | Actual Results |
---|
1 | 2006 | S.O. 1.3 - Improve health care quality, safety, cost and value | Mission and Business Results | Health Care Administration | Number of new quality measures implemented | 8 quality measures | 12 quality measures | 12 measures completed | 2 | 2006 | S.O. 1.3 - Improve health care quality, safety, cost and value | Customer Results | Response Time | Percent increase in Web-access speed | 25% | 50% speed increase in web-based access and upload | 50% target met | 3 | 2006 | S.O. 1.3 - Improve health care quality, safety, cost and value | Processes and Activities | Errors | Percentage validation accuracy found on records in final testing | 90% accuracy | 95% | greater than 95% | 4 | 2006 | S.O. 1.3 - Improve health care quality, safety, cost and value | Technology | User Satisfaction | Percentage of users filing complaints | 5% of users file complaints | 2% of users file complaints | less than 2% complaints | 5 | 2007 | S.O. 1.3 - Improve health care quality, safety, cost and value | Technology | Data Reliability and Quality | Percentage integration of the Online Survey Certification and Reporting System with HCQI | 0% integration | 50% integration | 50% integraton | 6 | 2007 | S.O. 1.3 - Improve health care quality, safety, cost and value | Mission and Business Results | Health Care Administration | Percent of surveys that rely on HCQI data | 60% of surveys | 80% of surveys | 80% | 7 | 2007 | S.O. 1.3 - Improve health care quality, safety, cost and value | Processes and Activities | Innovation and Improvement | Percent increase in web-based access speed | 25% | 50% | 50% | 8 | 2007 | S.O. 1.3 - Improve health care quality, safety, cost and value | Processes and Activities | Innovation and Improvement | Number of State users trained on HCQI reports | 0% users trained on new reports | 30% users trained | 30% | 9 | 2007 | S.O. 1.3 - Improve health care quality, safety, cost and value | Customer Results | Accuracy of Service or Product Delivered | Number of concurrent users served | 1000 | 1500 | 1500 | 10 | 2007 | S.O. 1.3 - Improve health care quality, safety, cost and value | Technology | Accessibility | Number of minutes to enter survey | 60 minutes | 30 minutes | 30 minutes | 11 | 2008 | S.O. 1.3 - Improve health care quality, safety, cost and value | Mission and Business Results | Health Care Administration | Percent of surveys that rely on HCQI data | 80% of surveys | 90% of surveys | | 12 | 2008 | S.O. 1.3 - Improve health care quality, safety, cost and value | Mission and Business Results | Access to Care | Number of OASIS outcome elements added or modified for home health agency pay for performance | 0% | 30% | | 13 | 2008 | S.O. 1.3 - Improve health care quality, safety, cost and value | Customer Results | Accuracy of Service or Product Delivered | Percent integrationof all CLIA application and Accrediting Organizations upload into HCQI | 0% | 30% | | 14 | 2008 | S.O. 1.3 - Improve health care quality, safety, cost and value | Processes and Activities | Innovation and Improvement | Number of State users trained on HCQI reports | 30% | 60% | | 15 | 2008 | S.O. 1.3 - Improve health care quality, safety, cost and value | Technology | Data Reliability and Quality | Percent integration of the Online Survey Certification and Reporting System with HCQI | 50% | 100% | | 16 | 2008 | S.O. 1.3 - Improve health care quality, safety, cost and value | Technology | Data Standardization or Tagging | Percent integration of National Provider Identifier into all standard reports and ASPEN | 0% | 30% | | 17 | 2009 | S.O. 1.3 - Improve health care quality, safety, cost and value | Customer Results | Accuracy of Service or Product Delivered | Percent integration of all CLIA application and Accrediting Organizatons upload into HCQI | 30% | 60% | | 18 | 2009 | S.O. 1.3 - Improve health care quality, safety, cost and value | Processes and Activities | Innovation and Improvement | Number of State users trained on HCQI reports | 60% | 80% | | 19 | 2009 | S.O. 1.3 - Improve health care quality, safety, cost and value | Technology | Data Standardization or Tagging | Percent integration of National Provider Identifier into all standard reports and ASPEN | 30% | 60% | | 20 | 2009 | S.O. 1.3 - Improve health care quality, safety, cost and value | Mission and Business Results | Access to Care | Number of OASIS outcome elements added or modified for home health aency pay for performance | 30% | 60% | | 21 | 2010 | S.O. 1.3 - Improve health care quality, safety, cost and value | Customer Results | Accuracy of Service or Product Delivered | Percent integration of all CLIA application and Accrediting Organizatons upload into HCQI | 60% | 100% | | 22 | 2010 | S.O. 1.3 - Improve health care quality, safety, cost and value | Processes and Activities | Innovation and Improvement | Number of State users trained on HCQI reports | 80% | 100% | | 23 | 2010 | S.O. 1.3 - Improve health care quality, safety, cost and value | Technology | Data Standardization or Tagging | Percent integration of National Provider Identifier into all standard reports and ASPEN | 60% | 100% | | 24 | 2010 | S.O. 1.3 - Improve health care quality, safety, cost and value | Mission and Business Results | Access to Care | Number of OASIS outcome elements added or modified for home health agency pay for performance | 60% | 100% | | 25 | 2011 | S.O. 1.3 - Improve health care quality, safety, cost and value | Mission and Business Results | Health Care Administration | Percentage of enhancements, new reports and new requirements integrated | 0% | 30% | | 26 | 2011 | S.O. 1.3 - Improve health care quality, safety, cost and value | Customer Results | Access | Percentage of users having access to new functionality | 0% | 40% | | 27 | 2011 | S.O. 1.3 - Improve health care quality, safety, cost and value | Processes and Activities | Innovation and Improvement | Percentage of users trained on new functionality | 0% | 40% | | 28 | 2011 | S.O. 1.3 - Improve health care quality, safety, cost and value | Technology | Reliability | Percentage of system availability | 92% | 94% | | 29 | 2012 | S.O. 1.3 - Improve health care quality, safety, cost and value | Mission and Business Results | Health Care Administration | Percentage of enhancements, new reports and new requirements integrated | 30% | 60% | | 30 | 2012 | S.O. 1.3 - Improve health care quality, safety, cost and value | Customer Results | Access | Percentage of users having access to new functionality | 40% | 80% | | 31 | 2012 | S.O. 1.3 - Improve health care quality, safety, cost and value | Processes and Activities | Innovation and Improvement | Percentage of users trained on new functionality | 40% | 80% | | 32 | 2012 | S.O. 1.3 - Improve health care quality, safety, cost and value | Technology | Reliability | Percentage of system availability | 94% | 96% | | 33 | 2013 | S.O. 1.3 - Improve health care quality, safety, cost and value | Mission and Business Results | Health Care Administration | Percentage of enhancements, new reports and new requirements integrated | 60% | 100% | | 34 | 2013 | S.O. 1.3 - Improve health care quality, safety, cost and value | Customer Results | Access | Percentage of users having access to new functionality | 80% | 100% | | 35 | 2013 | S.O. 1.3 - Improve health care quality, safety, cost and value | Processes and Activities | Innovation and Improvement | Percentage of users trained on new functionality | 80% | 100% | | 36 | 2013 | S.O. 1.3 - Improve health care quality, safety, cost and value | Technology | Reliability | Percentage of system availability | 96% | 98% | |
Enterprise Architecture In order to successfully address this area of the business case and capital asset plan you must ensure the investment is included in the agency's EA and Capital Planning and Investment Control (CPIC) process, and is mapped to and supports the FEA. You must also ensure the business case demonstrates the relationship between the investment and the business, performance, data, services, application, and technology layers of the agency's EA. - 1. Is this investment included in your agency's target enterprise architecture?
- yes
- 2. Is this investment included in the agency's EA Transition Strategy?
- yes
- 2.a. If yes, provide the investment name as identified in the Transition Strategy provided in the agency's most recent annual EA Assessment.
- CMS Quality Improvement and Evaluation System (QIES)
- 3. Is this investment identified in a completed (contains a target architecture) and approved segment architecture?
- no
- 4. Identify the service components funded by this major IT investment (e.g., knowledge management, content management, customer relationship management, etc.). Provide this information in the format of the following table. For detailed guidance regarding components, please refer to http://www.whitehouse.gov/omb/egov/.
Component: Use existing SRM Components or identify as NEW. A NEW component is one not already identified as a service component in the FEA SRM.
Reused Name and UPI: A reused component is one being funded by another investment, but being used by this investment. Rather than answer yes or no, identify the reused service component funded by the other investment and identify the other investment using the Unique Project Identifier (UPI) code from the OMB Ex 300 or Ex 53 submission.
Internal or External Reuse?: Internal reuse is within an agency. For example, one agency within a department is reusing a service component provided by another agency within the same department. External reuse is one agency within a department reusing a service component provided by another agency in another department. A good example of this is an E-Gov initiative service being reused by multiple organizations across the federal government.
Funding Percentage: Please provide the percentage of the BY requested funding amount used for each service component listed in the table. If external, provide the funding level transferred to another agency to pay for the service. Row | Agency Component Name | Agency Component Description | Service Type | Component | Reused Component Name | Reused UPI | Internal or External Reuse? | Funding % |
---|
1 | Data Cleansing | Defines the set of capabilities that support the removal of incorrect or unnecessary characters and data from a data source. | Data Management | Data Cleansing | | | No Reuse | 5 | 2 | Data Exchange | Defines the set of capabilities that support the interchange of information between multiple systems or applications; includes verification that transmitted data was received unaltered. | Data Management | Data Exchange | | | No Reuse | 6 | 3 | Data Warehouse | Defines the set of capabilities that support the archiving and storage of large volumes of data. | Data Management | Data Warehouse | | | No Reuse | 5 | 4 | Extraction and Transformation | Defines the set of capabilities that support the manipulation and change of data. | Data Management | Extraction and Transformation | | | No Reuse | 6 | 5 | Loading and Archiving | Defines the set of capabilities that support the population of a data source with external data. | Data Management | Loading and Archiving | | | No Reuse | 7 | 6 | Meta Data Management | Defines the set of capabilities that support the maintenance and administration of data that describes data. | Data Management | Meta Data Management | | | No Reuse | 5 | 7 | Data Integration | Defines the set of capabilities that support the organization of data from separate data sources into a single source using middleware or application integration and the modification of system data models to capture new information within a single system. | Development and Integration | Data Integration | | | No Reuse | 7 | 8 | Enterprise Application Integration | Defines the set of capabilities that support the redesigning of disparate information systems into one system that uses a common set of data structures and rules. | Development and Integration | Enterprise Application Integration | | | No Reuse | 4 | 9 | Software Development | Defines the set of capabilities that support the creation of both graphical and process application or system software. | Development and Integration | Software Development | | | No Reuse | 5 | 10 | Ad Hoc | Defines the set of capabilities that support the use of dynamic reports on an as needed basis. | Reporting | Ad Hoc | | | No Reuse | 10 | 11 | Standardized / Canned | Defines the set of capabilities that support the use of pre-conceived or pre-written reports. | Reporting | Standardized / Canned | | | No Reuse | 10 | 12 | Graphing / Charting | Defines the set of capabilities that support the presentation of information in the form of diagrams or tables. | Visualization | Graphing / Charting | | | No Reuse | 3 | 13 | Surveys | Defines the set of capabilities that are used to collect useful information from an organization's customers. | Customer Relationship Management | Surveys | | | No Reuse | 7 | 14 | Community Management | Defines the set of capabilities that support the administration of online groups that share common interests. | Communication | Community Management | | | No Reuse | 10 | 15 | Identification and Authentication | Defines the set of capabilities that support obtaining information about those parties attempting to log on to a system or application for security purposes and the validation of those users. | Security Management | Identification and Authentication | Identification and Authentication | 009-38-01-06-01-1030-00 | Internal | 6 |
- 5. To demonstrate how this major IT investment aligns with the FEA Technical Reference Model (TRM), please list the Service Areas, Categories, Standards, and Service Specifications supporting this IT investment.
FEA SRM Component: Service Components identified in the previous question should be entered in this column. Please enter multiple rows for FEA SRM Components supported by multiple TRM Service Specifications.
Service Specification: In the Service Specification field, Agencies should provide information on the specified technical standard or vendor product mapped to the FEA TRM Service Standard, including model or version numbers, as appropriate. Row | SRM Component | >Service Area | Service Category | Service Standard | Service Specification (i.e., vendor and product name) |
---|
1 | Software Development | Component Framework | Business Logic | Platform Dependent | MFC++, Visual C++ | 2 | Software Development | Component Framework | Business Logic | Platform Independent | C++, EJB, Java Script, JSF53 | 3 | Data Exchange | Component Framework | Data Interchange | Data Exchange | SOAP | 4 | Community Management | Component Framework | Data Management | Database Connectivity | TJDBC, ODBC, OCI | 5 | Ad Hoc | Component Framework | Data Management | Reporting and Analysis | OLAP, XML, Crystal Reports, JASPER iReport | 6 | Community Management | Component Framework | Presentation / Interface | Content Rendering | CSS, DHTML | 7 | Software Development | Component Framework | Presentation / Interface | Dynamic Server-Side Display | JSP | 8 | Software Development | Component Framework | Presentation / Interface | Static Display | HTML | 9 | Identification and Authentication | Component Framework | Security | Supporting Security Services | JAAS, WS Security | 10 | Community Management | Service Access and Delivery | Access Channels | Web Browser | Internet Explorer | 11 | Data Exchange | Service Access and Delivery | Delivery Channels | Internet | TBD | 12 | Data Exchange | Service Access and Delivery | Delivery Channels | Intranet | TBD | 13 | Data Exchange | Service Access and Delivery | Service Requirements | Hosting | TBD | 14 | Community Management | Service Access and Delivery | Service Requirements | Legislative / Compliance | Section 508, Security | 15 | Community Management | Service Access and Delivery | Service Transport | Service Transport | TCP, IP, HTTP, HTTPS, Secure FTP, SSH | 16 | Identification and Authentication | Service Access and Delivery | Service Transport | Supporting Network Services | DNS, LDAP, MIME | 17 | Data Warehouse | Service Interface and Integration | Integration | Enterprise Application Integration | TBD | 18 | Community Management | Service Interface and Integration | Interoperability | Data Format / Classification | XML | 19 | Data Warehouse | Service Platform and Infrastructure | Database / Storage | Database | Oracle, MS Access, SQL Server | 20 | Data Warehouse | Service Platform and Infrastructure | Database / Storage | Storage | SAN | 21 | Software Development | Service Platform and Infrastructure | Delivery Servers | Application Servers | BEA, Apache Tomcat | 22 | Software Development | Service Platform and Infrastructure | Delivery Servers | Web Servers | Apache | 23 | Software Development | Service Platform and Infrastructure | Software Engineering | Integrated Development Environment | Visual Studio, iReport Web Logic Workshop, Eclipse | 24 | Software Development | Service Platform and Infrastructure | Software Engineering | Software Configuration Management | Serena Dimensions | 25 | Software Development | Service Platform and Infrastructure | Support Platforms | Platform Dependent | Window 2003, Sun Solaris | 26 | Software Development | Service Platform and Infrastructure | Support Platforms | Platform Independent | Sun J2EE, Sun J2SE |
- 6. Will the application leverage existing components and/or applications across the Government (i.e., FirstGov, Pay.Gov, etc)?
- no
PART THREE
RISK You should perform a risk assessment during the early planning and initial concept phase of the investment's life-cycle, develop a risk-adjusted life-cycle cost estimate and a plan to eliminate, mitigate or manage risk, and be actively managing risk throughout the investment's life-cycle.
Answer the following questions to describe how you are managing investment risks. - 1. Does the investment have a Risk Management Plan?
- yes
- 1.a. If yes, what is the date of the plan?
- 2007-07-01
- 1.b. Has the Risk Management Plan been significantly changed since last year's submission to OMB?
- no
COST & SCHEDULE
- 1. Was operational analysis conducted?
- yes
- 1.a. If yes, provide the date the analysis was completed.
- 2007-07-27
- What were the results of your operational analysis?
- The project is currently within the 10 percent cost and schedule variance. We are on target to meet the milestones per the approved baseline. The system continues to meet the State Agency's requirements and needs.
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