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Federally Facilitated Exchange (FFE) Leveraging Alfresco with FFE

March 5, 2013

A humorous look at the challenge to obtain quality affordable care

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The Challenge and Key Drivers for Change

•  Patient Protection and Affordable Care Act (ACA), September 2010

•  U.S. legislation was passed to put American consumers back in charge of their health care and put an end to the worst abuses of the insurance industry, such as:

•  Denying coverage to children based on pre-existing conditions •  Dropping patient health coverage when they became sick •  Placing lifetime limits on benefits •  Providing access to affordable healthcare

•  Aimed to reduce paperwork and costs, increase transparency and quality of care, and more

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ACA Legislation Mandated

•  States to create an online competitive health insurance marketplace to provide individuals and small employers access to affordable health insurance.

•  Each state may construct its own exchange or the

Federal government will provide an exchange under regulations by the Federal Department of Health and Human Services

Ø Deadline for the implementation: October 1, 2013

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FFE Concept of Operations

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FFE Stakeholders

Consumers

Employers and

Employees

Navigator, Brokers

FFE States

SBE States

Federal Agencies

Issuers

White House and Congress

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FFE

Small Business

Employers and

Employees

Potentially 30 Million +

Individual and Web Brokers,

Navigators

States that will fully or partially

leverage FFE

Lots of political interest!

All major insurance

carriers in the nation

IRS, DHS, DoC, SSA States

building their own

exchange

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FFE ECM Requirements and Alfresco

•  Serve as the repository of all binary and raw data received from various stakeholders. Ability to retrieve raw data to support down stream business processes. Ability to retain and archive data as per federal policies

Store Unstructured Data

•  Associate flexible meta-data attributes with various documents/records to enable multi-tenancy, searchability and categorization

Flexible Meta-Data Management

•  Ability to scale vertically and horizontally to handle thousands of users and millions of documents Scalable

•  Support for open standards and APIs for integration with overall solution

Open Source and Vendor Neutral

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Design Considerations and Challenges

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•  Keep the content folder structure simple and intuitive, do not over-engineer

•  Organize metadata and structure by major applications and business domains that feel natural to users

•  Create a metadata hierarchy to simplify metadata management and improve metadata population

•  Make Repository tenant-aware where applicable •  Extensible folder and metadata structure so that it can

evolve with evolving business requirements •  Keep the solution portable and vendor neutral by

leveraging open standards for integration (e.g. OpenCMIS)

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Alfresco in FFE Architecture

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FEPS Enterprise Data

UI Layer - Mobile/Web Rich Internet Application (HTML, CSS, JavaScript)

REST Service SDK

FFE Content Services (ESB)

Ora

cle

(Rel

atio

nal

Dat

a R

epos

itory

)Enterprise Document

Management (Alfresco)

HTT

PS

(J

SO

N)

SO

AP

/Ja

va(X

ML)

Ope

nCM

IS

PresentationLayer

Data Layer

ApplicationLayer

JDBC

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Thank You !!!

Chirayu Desai (CD) Vice President Health and Compliance Programs Phone: 973-885-3876 Email: Chirayu.Desai@cgifederal.com