Modernizing health plan oversight
Medicare plan oversight depends on a mission-critical platform. Its legacy components needed modernization while protecting sensitive data and maintaining a dependable service for users.
New CMMI models required coordinated onboarding across several platforms. Provider vetting, document signing, and a mix of on-premises and cloud systems increased the number of handoffs.
Projected benefit from the proposed operating model. Realized savings not established.
The team connected Salesforce and RF with the 4i PECOS API, introduced e-signature workflows, and established an AWS environment as part of a broader migration and architecture improvement effort.
The Frontline capability statement projects approximately $2.2 million in operational cost savings to CMS from the migration. It does not establish realized savings or a reporting period; this figure is therefore presented as a projection.
Projection · not booked savingsMedicare plan oversight depends on a mission-critical platform. Its legacy components needed modernization while protecting sensitive data and maintaining a dependable service for users.
Enrollment for direct-contracting models needed a modern foundation. Complex transformation programming created a processing burden, while each new model required an effective onboarding path.
Real-time Medicare eligibility services require dependable access at national scale. The program also needed to transition operations, continue production support, and improve infrastructure efficiency.
Delivery brought together Salesforce, the RF platform, provider data APIs and electronic signatures to support model onboarding.
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