New 4iNNOVATION Platform

Cloud Development
HX
How the Centers for Medicare & Medicaid Innovation (the Innovation Center) is delivering a secure, intuitive management tool to Alternative Payment Model (APM) participants.
“I think that this invitation is awesome. I love that someone who already had access could assign access to another person.”
- 4innovation User
THE PROBLEM
Lack of consistency and synergy between platforms resulted in a poor user experience.
The Centers for Medicare & Medicaid Innovation (CMMI) conceptualizes a variety of innovative models every year. These models are onboarded to a variety of platforms creating a disjointed user experience for Entity users.
THE SOLUTION
The 4Innovation (4i) platform supports APM Entities in the submission of applications and management of participation in Alternative Payment Models (APMs) to improve the quality of care and reduce service costs. This system:
Support a variety of APMs Reduce the infrastructure blueprint and storage and operating costs Support Application Programming Interfaces (APIs)for data exchange(s) while providing flexibility and security Provide real-time feedback on Participant Medicare enrollment checks Consider end-to-end user experience and Human Centered Design (HCD) to drive the design decisions Simplify and centralize end-to-end business processes for models within CMMI Securely share sensitive Protected Health Information/Personally Identifiable Information (PHI/PII) documents with stakeholders through the DataHub
WHAT WE DID!
“I really, really like this Entity page. It’s helpful to have a one-stop shop for information about the organization-without having to go back into a document somewhere on file.”
- 4innovation User
By working with CMS, we defined an initial set of critical features (Minimum Viable Product – MVP) that are required to support Direct Contracting and KCC models for initial rollout. From there, additional features were incrementally identified, developed, and made available to users.
Identity Management and Okta Integration
Multi-Factor Authentication using CMS Enterprise Identity Management (EIDM) IDs
User/Contact Management
Invite users to access the system and manage users in their Entities
Agreement Management
Manage Entity application data
Participant Management
Get real-time feedback on participant Medicare enrollment checks for providers
Agreement Management
Manage Entity application data
My Agreements
Sign and manage Participation Agreements and HIPAA Disclosure Forms to access sensitive data
Reports & Analytics
View and download real-time reports related to agreements, participants, users’ access, and change requests for APM Entities
Data Hub
Securely access the sensitive data such as claims and beneficiary reports
Knowledge Management
Publish and manage model and system content (FAQs/Documents/ Articles/Events/Webinars)
API Management
Request and manage API keys and monitor API usage statistics
INSTEAD OF WORDS,
LET THE NUMBERS SPEAK.
3
Onboarded Direct Contracting & Kidney Care Choice (KCC) Models
1,022
Combined entities for Direct Contracting/ KCC in first Performance Year
27,162
Combined active users for Direct Contracting/KCC in a performance year
1,157,890
Combined active participants for Direct Contracting/KCC in a performance year
HOW WE DID IT?
“I really, really like this Entity page. It’s helpful to have a one-stop shop for information about the organization-without having to go back into a document somewhere on file.”
- 4innovation User
Modern technology
Developed and maintained microservices/serverless-based architecture. Built-in automated security controls. Elastic infrastructure/auto-scaling to support unpredictable periodic workloads.
APIs
Adopted CMS’ API First initiative to define API design patterns, security, and monitoring. Developed API using the most suitable programming language-based performance and computational requirements (Polyglot architecture).
Reducing Costs Through Tenets
Re-use before developing new; open-source before custom code.
Human-Centered Design Approach
Applied Softrams’ Human-Experience Design Framework by conducting research throughout the Discovery, Design, and Development processes. Led usability testing with actual 4i end users, ensuring an intuitive, clear interface.
SAFe Framework for Faster and Predictable Delivery
Implemented a Scaled Agile Framework combining Agile and Lean principles to deliver incremental value to stakeholders resulting in improved predictability, accountability, quality and overall value to the stakeholders.