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Readying Medicare and Medicaid IT Systems to Meet Emerging Demands: New Report

 

The mission of the Centers for Medicare and Medicaid Services (CMS) is shifting from one primarily concerned with claims payment to one centered on improving the efficiency, quality, safety, and equity of U.S. health care services.  CMS is also responsible for testing innovative care and payment models and overseeing and supporting the state-based insurance exchanges called for in the 2010 Patient Protection and Affordable Care Act.  In light of these challenges, CMS asked the National Research Council to review the centers’ plans for modernizing and developing its information systems. 

 

The resulting report, STRATEGIES AND PRIORITIES FOR INFORMATION TECHNOLOGY AT THE CENTERS FOR MEDICARE AND MEDICAID SERVICES, recommends that the organization move from viewing IT as simply an operational necessity to embracing it as a critical strategic element.  The IT leadership will need to play a key role in planning, designing solutions, and advising CMS business leaders, and CMS leadership will need to be integrally involved in decision -making about IT.

 

The report also advises CMS to adopt a strategic plan for the entire organization in concert with a well-aligned strategic technology plan to address the specific requirements of the IT infrastructure.  There should be no expectation on the part of CMS or its stakeholders, the report cautions, of an “ultimate” or finished CMS IT system, because a successful system will need to evolve as requirements change. 

 

The report is available for immediate release.  Reporters who wish to obtain copies should contact the Office of News and Public Information; tel. 202-334-2138 or e-mail news@nas.edu.