CMS to revamp IT systems for better integration and service

A new approach will help provide a foundation for transforming the agency into a "data-driven business," officials say.

By Chris Silva — Posted Jan. 14, 2011

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The Centers for Medicare & Medicaid Services is engaging in a massive overhaul of its health information technology systems in an attempt to integrate them more efficiently and provide improved quality information for physicians and patients.

At the center of CMS' vision are new installations or configurations, dubbed "Greenfield projects," which will provide the foundation for transforming the agency into what officials describe as a "data-driven business." For example, the agency is attempting to develop a single source of data information to share between Medicaid and the Children's Health Insurance Program. This would help support advanced levels of IT platforms and promote greater transparency, the agency said.

CMS is focusing on two main goals: to obtain more robust analytics for quality of care in relation to new health care delivery models and to drive quality improvements by rewarding physicians based on performance metrics.

In addition, CMS said the new strategy will help it establish the necessary capabilities to achieve:

  • Improved business operations -- by transitioning to flexible payment methods that integrate administrative claims, encounters, clinical payment and outcomes data.
  • Effective performance measurement -- by enhancing oversight of the wide range of quality activities and payment systems for Medicare, Medicaid and CHIP.
  • Enhanced public accountability -- by streamlining program, billing and eligibility information to boost information availability and reduce burdensome procedures such as physician enrollment and claim processing.
  • Innovation -- by offering modern, analytical IT capabilities for cost and quality, supported by reliable storage systems and fully integrated enterprise-level databases.

The health reform law required the development of a plan for modernizing CMS computer and data systems. CMS said its effort will be phased in gradually and that it expects the changes to "generate significant program savings and lower administrative costs."

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