Medicare Needs To Elevate IT Approach, Says NRC

November 17, 2011
FedCyber Wire, Requirements
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As the Centers for Medicare and Medicaid Services (CMS) confronts a large number of new IT challenges, such as supporting state insurance exchanges and testing new reimbursement and care delivery models, it must transform its approach to IT systems. So says a new report from the National Research Council, commissioned by CMS.

The NRC study recommends that the agency shift from viewing the IT function as an operational necessity to seeing it as a “critical strategic element.” The report also advises CMS to draw up a long-term strategic plan that treats its IT capabilities as an integral component of its strategy.

“IT is at the heart of virtually every CMS business interaction, process, and decision,” says the report. Therefore, the study suggests, it’s not sufficient to simply upgrade and modernize the agency’s systems, which are of varying age and staggering complexity. The systems must be aligned with the agency’s overall goals.

The overall transformation of CMS systems, the report says, should be based on the reality that the agency is changing its primary function: Instead of simply being a huge claims processor, it is now combining Medicare and Medicaid reimbursement with a focus on “improvements in quality, safety, and equity of healthcare and outcomes for individuals and populations.”

via InformationWeek Government, continued here.