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 andsystem 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.

2

Onboarded Direct Contracting & Kidney Care Choice (KCC) Models

438

Combined entities for Direct Contracting/ KCC in first Performance Year

3195

Combined active users for Direct Contracting/KCC in a performance year

95018

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.