Accountable Care Organization Management System (ACO-MS)

CLOUD
HUMAN EXPERIENCE
Client
The Centers for Medicare & Medicaid Services (CMS)
INDUSTRY
Healthcare
INDUSTRY
Healthcare
Website
www.cms.gov
SUMMARY

The Accountable Care Organization Management System (ACO-MS) is a tool used to manage the Medicare Shared Savings Program (SSP) and the Medicare Electronic Application Request Information System (MEARiS™). Our team redesigned ACO-MS to modernize the system to better support the case management and workflow of the ACOs and Center for Medicare (CM) users. ACO-MS is backbone system providing a foundation for managing Centers for Medicare & Medicaid Services’ (CMS) high-priority Pathways to Success initiative.

$1.8B
in savings in 2022
10.9M
beneficiaries served by SSP ACOs
91%
average overall quality score
6
consecutive years of savings and high-quality care
$8K
saved per month for CMS
CHALLENGE
Reimagining the Future of an Outdated Application

The Shared Savings Program expanded substantially within its first several years of operation, growing in scope to accommodate over 500 Accountable Care Organizations. As the demands surrounding the SSP increased, the legacy application began to show signs of depreciation. The legacy architecture had been built to utilize two data repositories, which needed to be kept in sync and were expensive to maintain. ACOs struggled to generate, manage, and maintain reliable process workflows using the system.

SOLUTION
A First-of-its-Kind System Built to Last

ACO-MS is the first system of its kind to use a Docker-based, containerized microservices architecture. ACO-MS runs on a reliable Softrams-built AWS cloud platform, with open-source technologies used to streamline process workflows, user experience, and product expansion. With scalable and highly operational technologies at its core, ACO-MS allows users to conduct real-time data validations, automate program deliverables, and reduce application run cycles.

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OUTCOMES
Benefits to Users at All Levels

ACO-MS leverages modern scalable architecture combined with Agile delivery and a human-centered design approach to meet the expanding needs of Shared Savings Program ACOs, CMS staff, and other stakeholders. 

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  • Operational cost savings for CMS: By establishing one data repository as a single source of truth, we were able to decrease operational costs – approximately $8,000 per month. 
  • Reduced processing and data retrieval time: Modernized architecture allows users to retrieve data quickly on-demand, as well as quickly stand up new models and deploy system updates. 
  • Improved user experience: ACO-MS provides its users with fast, efficient, and accurate data storage and analysis with access to critical features including Elastic Search, Knowledge Library, and real-time Provider, Enrollment, Chain & Ownership System (PECOS) validation. 
AWS SERVICES USED
  • Lambda, Elastic Compute Cloud (EC2), Batch, and Route53 are used to manage ACO-MS’ scalable, serverless environment.
  • AWS Elasticsearch, AWS Simple Storage Service (S3), Amazon Relational Database Service (RDS), AWS CloudWatch, and Amazon CloudFront are implemented to meet data demands.
  • API Gateway, AWS Secrets Manager, AWS Key Management Service (KMS), and Identity and Access Management (IAM) roles maintain a reliable and secure environment.
  • Amazon Elastic Container Service (ECS), Amazon Elastic Container Registry (ECR), Amazon EventBridge, and Amazon Simple Queue Service (SQS) to manage the microservices ecosystem.
Thank you all for your dedication to making sure we capture necessary revisions and functionality improvements throughout this RFA-to-web effort............. Finally, thank you…for being such generous partners with your time, understanding, and patience as this tracked our clearance process in parallel, which made for a tricky final few weeks.

CTS CMS Stakeholder

I want to thank you for all of your collaboration and support through the bid submission system changes this year. Large-scale system changes are always challenging to manage across the various parties and I’m sure it required heroic efforts on your side. I really appreciated the upfront engagement during the development process and, of course, the daily support at the end to resolve API issues. My team and I are thrilled to be done with the PBP software! Thank you again.

Position, Company name

MDP program received Zero Findings as well in the assessment. This is good news for MDP. The recent quarterly Rebate Calculation assessment of the MDP found no errors and no mentionable discrepancies. This is an unusual first in that the assessors always seem to find something amiss. Good work everybody

CMS MDP stakeholder