CMS Needs YOU to Help Them Transform

By Jessica Parks, Analyst

In this era of widespread government IT transformation driven by Cloud Smart, FITARA and other initiatives, technology vendors can face difficulty in knowing where to most effectively focus their efforts.

In this blog I put the spotlight on the Centers for Medicare and Medicaid Services (CMS) as one potential hotspot for you to focus on for 2020 – and beyond. I recently attended the AFCEA Bethesda Health IT Summit and gained valuable insight into the CMS modernization journey and its future objectives.

Read on for a couple of target areas for vendors and how you can strategize accordingly.

Data and Analytics

CMS aims to help both researchers and internal teams gain insight from its rich trove of data. As CMS Chief Data Officer Allison Oelschlaeger noted, they are “looking to industry to build those tools to present data in ways that are meaningful.” In particular, you will want to keep your eyes peeled for opportunities in the MACBIS program, which stores data for Medicaid and CHIP beneficiaries. CMS is experiencing some issues with data quality in the T-MSIS system that collects data from states and is housed under MACBIS.

If you offer data quality tools – especially automated tools to help shorten the process – talk to CMS about how your solution will enhance the efforts of their Integrated Data Repository team to better use that data to uncover instances of fraud and waste. Additionally, the Data and Systems Group intends on releasing a competitive solicitation for MACBIS Analytics in May 2020, so this is a priority that is clearly at the forefront for CMS.

Automation

Automation and machine learning are technologies that have been embraced by HHS as a whole and CMS is swimming in the same current. CMS has introduced automation in limited instances but is looking to this emerging technology as a future goal. For the T-MSIS system, Julie Boughn, Director of the Data and Systems Group at the Center for Medicaid and CHIP, said that they have introduced automated tools to better support their activities with the states. Zabeen Chong, Director for the Provider Enrollment and Oversight Group in the Center for Program Integrity, stated that for Medicare’s PECOS system, they are looking to “remove human interaction as much as possible” to more quickly process the steady stream of provider enrollment applications.

Think about tools that will eliminate steps or support low-level tasks – for example, solutions that support data reuse, so information has to be entered just once. Be sure to communicate to CMS exactly how your tool will result in time and cost savings for their teams.

These specific areas are simply one piece of a larger plan to modernize – CMS released a comprehensive 16-point plan in December 2019. However, data analytics and automation are two areas of fertile ground for vendors, whether you have an established relationship with CMS or are looking for a solid point of entry.

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On-demand videos from the 2019 Government IT Sales Summit are now available. View the Civilian Market Intelligence Briefing to hear more about opportunities across government. The presentation is available for downloading.