In an effort to support a healthier, more equitable public, we’ve partnered with The Centers for Medicare & Medicaid Services (CMS) on The Medicare Payment System Modernization (MPSM) program. Existing sources of claims data have about a month of lag time from the filing of the claim before the claim is available on the cloud. Our API reduced this window to 24 hours after the claim is filed, transferring approximately 15 million claims per day.
Nava is working with CMS on their MPSM program to create a flexible, scalable system that serves over 60 million Americans and accounts for 14 percent of the federal budget. Our shared vision is to ensure that these critical systems are able to adapt to evolving Medicare policy and program needs, supporting a healthier, more equitable public.
Over the past year, Nava’s Operations and System Reliability Engineering (OSRE) team—the team dedicated to building and operating the infrastructure for MPSM’s cloud-based services—created a system health status page for CMS staff and contractors who are responsible for processing over 1 billion claims a year. The status page centralized and automated the process for alerting CMS staff and contractors when any part of the technology system experiences an outage or other incidents. By using cloud technology to make this information accessible in real-time, the Nava team radically improved the speed and transparency of a previously cumbersome process that relied on email communication. The status page reduces the time it takes to resolve incidents when they occur.
Unlocking healthcare data can help improve patient outcomes and lower taxpayer burdens
As part of the Medicare modernization effort, our team is also building a system for transferring valuable data from mainframe systems to the cloud and making that data more accessible, helping to unlock patient data for healthcare providers. Currently, claims data for millions of patients sits on older mainframe systems. But cloud-stored claims data has the potential to help providers improve patient outcomes while lowering the overall cost of care paid by taxpayers. A doctor whose patient visits an emergency room out of state, for example, would be notified about the visit within a few days of it happening, ultimately helping the provider offer more informed care for their patient.
Existing sources of claims data have about a month of lag time from the filing of the claim before the claim is available. Our API makes these claims available within 24 hours after the claim is filed, transferring approximately 15 million claims per day onto CMS’s cloud platform.
Advancing health care with tools that collect crucial patient information
In the past year, we also helped CMS prototype tools to systematically collect demographic data and other key information about patients as part of a goal to advance health equity. Following the directive from the Biden administration on moving toward health equity, Nava’s team worked with the CMS Innovation Center to develop questionnaires that collect basic demographic and Social determinants of health (SDOH) data from beneficiaries.
Gathering information from patients such as their race, ethnicity, housing status, and job status will help build a baseline for CMS to assess the health equity and inform policy changes to improve the nation’s health. This work leverages the Fast Healthcare Interoperability Resources (FHIR) standard, a technological standard for sharing electronic health records. Using this data, CMS can work toward its larger goal of building more equitable health outcomes across the American public.
