Introduction
Client Background
The Center for Medicare & Medicaid Services (CMS) is a U.S. government agency that administers Medicare and Medicaid, overseeing healthcare delivery and program integrity.
Project Goal
The goal was to streamline CMS operations, enhance process efficiency, and reduce delays across departments such as Medicare Advantage, audits, and data management.
Project Timeline
— 2010 to 2012, involving multiple phases and departments
Research/Discovery
Planning
Execution
Deployment
Testing/Iteration
Challenge
Inefficient processes, resource drain, and redundant audits hindered operational efficiency.
- Delays in approval, audits, and responses to provider applications and correspondence.
- High resource consumption, including reviewing 50 marketing pieces with a 45-day turnaround.
- Redundant audits and data capture created inefficiencies and a burdensome environment for providers.
Solutions
Strategy
Cannsult worked with multiple CMS departments to improve operations, reduce cycle times, and enhance data accuracy, identifying bottlenecks and proposing targeted solutions for each area.
Approach:
- Focused on data-driven decision-making, automation, and process standardization.
- Fostered cross-departmental collaboration to enhance overall efficiency.
- Applied Lean Six Sigma techniques to eliminate inefficiencies and streamline key processes.
Execution:
- Streamlined access to compliance data and improved audit coordination, reducing delays and redundant tasks.
- Improved efficiency by reducing time spent on reviewing marketing materials and responding to CMS inquiries.
- Enhanced SAP data accuracy, ensuring timely raw material availability and reducing errors.
Results
30%
Reduction in approval delays for provider applications and audits.
25%
Decrease in provider audit burden through better audit coordination.
20%
Improvement in operational efficiency and process standardization.
98%
Data accuracy, improving decision-making and reducing errors.
Conclusion
Cannsult’s collaboration with CMS resulted in meaningful process improvements, enhanced data accuracy, and reduced operational costs. These changes streamlined CMS functions and improved service to beneficiaries and partners.
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