“The Centers for Medicare and Medicaid Services (CMS) is not modernizing for modernization’s sake. Instead, its IT developments are driven by mission and use cases.”
“As part of its modernization initiative, CMS is strategically moving its business processes to the cloud rather than relying on a ‘lift-and-shift’ method.”
“’From the business side, for the last three years we’ve been working on modernizing the claims payment system and starting to move that to the cloud,’ said Misu Tasnim, executive director of digital services for CMS, at GovCIO’s Infrastructure: Health IT event. ‘It is a 50- or 60-year-old system where we have put policy on top of policy over the last few decades. So, it is a complicated system to modernize, but three years ago we started this journey and we have made a ton of progress. Now we have a cloud environment, and we’re slowly working our way and moving that business logic into the cloud and thinking very strategically about it, so it’s not just lift-and-shift.'”
“Modernizing the claims payment system is no simple task, but it will result in improved data accessibility and analysis capabilities for CMS.”
“’We have 40 million Americans that are in the Medicare Fee-for-Service program and 1.2 billion claims being processed each year,’ said Mary Greene, director of the Office of Burden Reduction and Health Informatics at CMS. ‘There’s different kinds of claims depending on whether you’re an institutional provider or whether you’re an individual clinician. … And that system varies depending on what kind of institutional provider you are. So, not only is part of the challenge here moving into the cloud environment, it’s also how to keep all that data up to date and how to maintain the nuances of the various policies across the different programs. It’s complex, it’s tough, but it’s important to sort that out because of the end users who need to find specific claims for specific programs when they’re doing their analysis.'”
“Ben Cushing, chief architect for federal health at Red Hat, emphasized the importance of relying on use cases to drive and guide federal modernization.”
“’You don’t just modernize for the sake of modernization,’ said Cushing. ‘Now that we have the compute, we need to actually execute those activities we just couldn’t do before on-prem. … Modernization, especially for a federal agency, has to happen against mission, right? How does it impact mission? Because otherwise you’re wasting taxpayer dollars…'” Read the full article here.
Source: CMS Making Strides on Mission-Driven Modernization – By Katherine MacPhail, April 1, 2022. GovCIO.
