CMS developing new IT opportunities around geospatial, analytics and eligibility

With billions of dollars in its budget, the Centers for Medicare and Medicaid Services has several procurements in the works aimed at modernization and improving operations.

“We are always looking for ways that we can reduce costs, bringing in greater innovation and efficiencies,” said Donald Knode Jr., IT Contracts Group director, Office of Acquisition and Grants Management, CMS.

Knode spoke with a number of other HHS experts on Thursday at Washington Technology’s Health and Human Services Industry Day.

“We’re currently building our 2017 forecast, and by the end of October, we’ll have that forecast posted,” Knode said.

But he did offer up some information on upcoming opportunities and procurements:

CMS’ Common Working File, a Medicare tool that determines the eligibility of patients and to monitor the usage of Medicare benefits, will be procured by the agency soon, Knode said.

“We’ll also be doing a recompetition on our Exchange Help Desk,” he added.

Other recompetes include one for the agency’s Data Services Hub, which will help with verifying applicant information used to determine eligibility for enrollment in qualified health plans and insurance affordability programs, according to the CMS website.

The hub will provide one connection to common federal data sources (including but not limited to SSA, IRS, DHS) needed to verify consumer application information for income, citizenship, immigration status and access to minimum essential coverage.

CMS also has a competition coming up for an open payment system, which is a federal program that collects information about the payments drug and device companies make to physicians and teaching hospitals for things like travel, research, gifts, speaking fees, and meals, as mandated by the Affordable Care Act.

The open payment system is part of the National Physician Payment Transparency Program, Knobe told the audience, which requires manufacturers of pharmaceuticals or medical devices to publically report payments made to physicians and teaching hospitals creating greater transparency around the financial relationships that occur among them.

Lastly, Knode said, CMS has a competition coming up for geospatial Medicare analysis.

Knode said in his presentation that future investments beyond these include IT modernization for Medicare and Medicaid claims systems, enhanced security resources, updates to critical programs, and maximizing portfolio effectiveness.