LMI wins trio of CMS health care services contracts

Contracts call for operational support and helping CMS develop business processes and data analytics.

Government consulting firm LMI recently won three new contracts from the Centers for Medicare and Medicaid Services worth a total of $58.7 million over five years for a variety of health-care related IT services.

In the first of the three contracts, LMI will provide analytic and operational support for CMS’ Medicare Shared Savings Program.

The tools and metrics developed by LMI for this new program, which was established under the Affordable Care Act (ACA), will enable the monitoring and compliance of the program.

LMI’s work will allow CMS to focus on identifying savings on care to beneficiaries, as well as identifying trends and patterns suggestive of avoidance of at-risk beneficiaries. LMI will also help locate inappropriate overutilization of services or referrals according to the company’s recent news release.

The other two contracts focus on programs created by the ACA.

Accountable care organizations (ACOs), a new model of healthcare delivery systems, are designed to better coordinate care and reduce costs for Medicare beneficiaries.

LMI will help CMS develop business processes and data analytics for monitoring and auditing the progress of these ACOs as they work toward improved quality goals and reduced Medicare costs.

For health insurance exchanges, LMI will assist CMS’s Center for Consumer Information and Insurance Oversight develop the Federally Facilitated Exchange, or FFE, a public marketplace for individuals and small businesses to purchase health insurance.

The McLean, Va., government consultancy will help design the procurement process for soliciting plans that will be offered on the FFE, develop cost models for operating the exchange and processes for certifying “qualified health plans,” and assist CMS with providing technical assistance to the states.

LMI also will help review insurance plan submissions annually for compliance with FFE standards if the option years are extended.

“LMI has invested more than 15 years in earning the confidence of CMS through our work on Medicare Advantage, HIGLAS [Healthcare Integrated General Ledger Accounting System] and One PI programs,” LMI President and CEO Nelson Ford said in the announcement.