The Shared Savings Program (SSP) within Medicare serves 10,500,000 Medicare beneficiaries enrolled in 500+ Accountable Care Organizations (ACOs). Since program inception in 2011, SSP ACO participation has increased to 500+ ACOs with a user base of 6,000 – 7,000 administrative and program. To meet this growth and add flexibility to expand operational activities, CMS needed to develop and deploy a secure, FISMA-compliant solution to support ACO application, contract, and administrative processes. This solution needed to reduce burden on administrative and program staff through improved data management, customized workflows, and real-time reporting through technology chosen to meet the flexibility and scalability needs of this rapidly growing program.
A system that allows application submission, application tracking, application review and approval
Notice of intent to apply entry, tracking, review and approval process
Executive dashboards and reports, program overview snapshots with ACO risk ranking
We conducted design reviews around extracting business rules and compliance checks for SSP participation, tracking changes, and terminations in manageable and configurable modules. Our prototyping, UX research, and testing focused on reducing burden for users as well as program staff to effectively manage these complex Medicare programs.
Using Agile methodology, we designed and built a cloud-based, workflow solution that would support extensive inbound and outbound data exchange capability within a front-end operational data store and service hub. The custom application is built using a MEAN (with MySQL, Express, Angular, and Node) technology stack using a modern, scalable, open source framework. The performance architecture includes multiple availability zones in Amazon Web Services (AWS).
Softrams team members built the database AWS RDS environment and built the logical and physical data base design instances of the MySQL database. This database was chosen because it is a powerful, open source object-relational database system with features that safely store and scale complicated data workloads.
As part of Phase 1, we designed and developed the data warehouse, migrated legacy data into the new RDS environment, integrated single sign on (SSO) and multi-factor authentication via APIs within enterprise security components, incorporated operational and performance metrics, and reporting dashboards tailored to ACO cohorts. This provided a functional product that received ATO to support annual processing in April 2018 – eight months after contract award.
Softrams implemented a Microservices based architecture using Continuous Integration, Deployment and Configuration Management (infrastructure as code) to rapidly develop a modern application in the cloud within 8 months of contract award. We delivered Phase 1, devoted to designing, building and implementing core web functionality, and have continued to work closely with our customers to enhance operations through
additional services to support ACO functions and CMS administrative tasks. We are currently working in Option Year 1 creating a library/inventory of existing Knowledge Management content (announcements, events and resources), migrating it from the existing platform to a newly designed and developed module, managing ACO announcements, events and resources to make existing and new content available to ACOs.