Medicare Transactions A550 milion ssn in pret management By Brian Friel ‘The Heath Cae Financing Adniniscaton, te agency tat dns Meat, pes yes, For 1991 to 1957, ae least 930 eon dereosinatie Meticae Tansitin Sytem ‘Tosay FICEA 82 page statge pa Br lafornatonteuolony ovr te next five years aks po menin oftheil-fited syste instead on ‘aking oblquerefencest th exon oft HEPA TT invert ffi" HEPA Cher eformation Otox Gry Cweopt, who Wasted te NTS dewlopment was cacee ay the gem mong "Some he enemas MTS were rely you conmeps. Where we fe down vas he inplmestaio,* Chrstoh ys "When ute rowing wp, you fi lan ere thes nl, en then idea ye. You doc Js junp ino arora” “i ian of HCE compute poles yi eenlaguces Congres wens tous potas ete eas nt he een dons gamer a ation ue eh am, uiagrous ropes igus pares wd ances {Gren The ssens ao prepay ig aro fae ‘ate or et eto sani) od wien nlangge ope inte 1950 an! sts seas COBOL ‘Tha, sometime in the 98, dams nth ageney tat ie systems are ‘becomng manageable. Soit decides bud one arg, inegrated sje ta atthe agua programe a ston xpd reap Igo est onnge ovr ime (er ssigBowt up font erat, 32 course) Ovni on sytem i ovo lea expense than mara Imutiplegrtens. Techlony managers pict that lorus day about fe years dow the oad when ey wil atthe bos, wnat th sysemandbas inthe apple of te agency alessio, dota ‘embers of Congres aad chewing ape, ‘But yor know wha happen inte, [ULHRA case, te agency ised a reuast or propos fr s mezn- sysemon Sept 17,1982, Ever before the ell i ders the ret, the ‘reuh and uman Serees Departmen: npecae general ecommendedthat HCFA pause and "tlw a more ately odentad aprsach ssraleing couotdeing ed integrating Medicare aims process Four month afr request for propos went cu th inpecor genera suggested tat FICFA eee to more ceri dene what ely he ‘gens nated tne Maaare Trasaston Stem todo The1O Usd recommended tht HCFA aks aur contents nar ha Medicare ib acomtanly changing program tht prods feeble, dapatle stare Inresponse, HCFA stained 11 work groupsto came varus specs of Movinrpreconing nd provide lnemnionte te oneastr Late, the nuber oF work gros would te enpanied 0 38. In th mtaninis HCPA snared OTE Gover Series the MTS onactin lanay (94, a Apel 1998, HCPA hie Imereti I, Sal T company is Vgins now knowns Aveta, indepen IHoutor he cous’ props "This new stem wl bingo aly anew eraof castomer service nd onveninse fr Meicae eiaesbemed HIS Sener) Deana Silla ina Janeary 199 pes elane "Ie wes stat-ofthe art cts to replae te forms and thebaestht ive caraered edear in ‘Me pst" The sre would be completed ne 198, he reese (GTE bese placing ts sae to beip HCFA combine ino one 9m. Mescare’s 13 sstns x 50 operated by more han 70 contac, \shiethe work groupe iedto ae sre fh gia’ sstane arctitecure| Danger Signe ‘The dargcr signs wer lod, In Dect 1994, the impor goal sgn warned HCPA thet wast ping GTE enough information bed the contactor sla forte comglenies of Medcareprocesing The folowing yer, HCFA asued the 1G ta iad begun providing ample infomaonto OTE Th ten way or rac fer al splonenation b Sepenber 998, HCFA wit. In November 1895, the GoreralAceourting Ofc ighighied wv onze it ad with MES fa rpot tothe House Goverment Ref (Commits, neadrg acter cemact requemens a Ugh schol anda Tack rele oat bene brnaon ThensHCFA Acmitstrtor Brae Vadeck esponde: "Weare well aware ‘hat hia is highrise venue We ae sondage projet wah akeot spprecntion ofthe nod to nage be fesse” ‘ si1996, Ics nar HICFA ant GTE dt the MT evelopment sekeile ha ao may overagping anestones, het wing wet uaheeded anlnermetics offal would est at House esangia ay 1907Aonth fie tat ing, HCEA crderad GTEto op work fx 90 days ‘nallbutone of te segment of MS to vaste te ewons rhe Pests rating cor vars and mies cen By May 1997, OAO was soe adamant ht NTS wa in big tote EEA ha et plane! the pnjecs hedle wel enough di ot have P Inetuesto gauge progres andbad fale o use ect brett sales ata her toas fe com tack wi aves whee Ss cpat on MET wl core toa tur onthisinvestest” GAO sd (TAIMD-9791) Inaddon, th projected costs of MTS had ‘susvoonod fon $1 millenia GAO esoned nat HCFA fd open! $80 alone pois 2 though HCPA cys the tot ‘Spenton MTS wes $5 ilion Te reponse, HCFA, GTE ani even Iter vowed at MTS would be ‘compete bei probaly ne wel 2300. “Ther meth eter, HCFA cancel is cet with GTE. "Too Much Conddeace! We hd one maj sak ie the We of ite MTS] expen, wd that ‘one roby hing son much concen te ality ofthe onracor To dave," frmaradniasror Vadose sa ‘Un mi-1998, HCFA continued to work onredhcing the sunbe of ‘pve tale en, Tenis uspindelalleolerazaton eff te make fre aro mien tae 9 sftate cde were seo potential 2K icles HCPA dita. coms ot ofthe MTS projet cemphtaly empty tani. The ‘gen i cat dew the suber af onc ad shes mara [diearepracesng stems aod ingress 1 ste io Ta ‘on the prot pve aguney oli abt undersandng thew ther ayson wich ee conoid prima by eartnctrs, epee, "HCPA came ou of [MTS] with auch learer shor fo medion tom ‘eaegy for manag eae processing," Vides sy. 1a fst Vlndeck ye that MTS grub illcnul ave be salragad fier GTS ile, excogt to ctr, Ft, Congres andthe Clinton ‘nissan fledo Snr nay ofthe betes thal woud sy tect o an expontve ing, iteptedeystem induding tt rd ‘etowioe and improverents n pocesine eEcency. Seco, the projet fl wit tothe stl reals ion, it championed by forme: Oe htanagement na Budget Diretor Frauke Rates st sgl "i> Tang" procurements jist dont work. "Atte sinc the exe nansh ns a9 docinated by Dire Raine “nosn fo sige compretenveprocaenens tat een hough vou ‘ul sl make sn ele egument foe METS, welt in ead ‘hy shee of coving ON, Visdexk Says“Th prj tala ty eazthe ison spony Shahan 1934. These lo sil system fr Medea: prceaing. Astin io BEX row ‘ive information technology pln cure sens stl “deasy ‘fet busbas nyse des osoplies aan re why fs ‘example, cm precesng was agely paper hanling futon. (Media rocesing satens and HCPA cena ote It insure ‘eon svpanialy arto ae teohadiog plement 10 13 eas ‘ge pia operating on newer equip LCEA‘s not mach beter of ow than tas i198, pst cae the teemoogy sa har spt oe as vo fas rolung YEKprclens. But HCFA id lea loons fem he effort wich we fected the ageaejs pew IT states pan + Secceaatiomiltons HCFA‘ covtast wih GTE steal fue he contasortiee years bits fal pacage Az ‘Gstment ote cect equingineremeral dele of {ofvar came oo sand ove un CEA allowed mest to ‘val and did poor ob motoring GTE'promen, HCFA ‘ow pins uss “oda contacting” which spate: Imotemzuon atots ino tet pases under eprate cOnaes. + Keow what you wast Before you a fort Not oy dd HCFA aot shave a complete grasp on he fs ates ofetaod, false. teving ther reno GTE wt cena ore apparent hat he ‘molemiaton eon ws vey complex + Aid asin eo New guramts pe geting tacked oats MIS, "There ae staves ad wanesaves You carl the arnataves outage ngs you must have." CrizopE Sys, "You dont wae yur energy cn tangsthat ee iets" 1+ Hie a invesinent review process, The MTS efor was kept cer eer sertin by an eral anageict Dodo Indepenion valdatonconvaco, th spect gens fice 1nd the Gereral Aseouring Offce But despite ayes of overs, ‘her as mo stucured vest resew proce HCFA Bs tine rated mut a proceso ele retvn om isezment, ‘eablt peoraanoe meaaures ta tecinaogy eos t agstcs Ines: betes deny rik tht euld del vesmens, set (uta dela schecul or sccomplsug ll pasts Of ays. ‘Slonsra hat jorcarn as consiet wh the gency vel etnolegy achtecure. "We davloped an itera vison fat cide ot jt laine prscesina” Cisophsays "We vanto bud an eerris-wie Firion ttre ta dace ais coe Then we wl ve feterpinedtabane tat ne acealoto al our plications at txedthe ‘ea ripeas“+ Manage epetatons HCFA pronisid te moon but deter lie Thejoo of ting out te agen pry daeunecid ended foc ttre syne a uensly ener HCPA ‘ue plan exp the icles af ecoverg om er of poor ‘Fintan la ato, the Sve year pan deseres sow td sont erento noderising he agemyeeyem. + Rede sik, HCFA‘snew Sve-year plan calls for paomancs- Raed contrarting for I pacts eh oonive payers edt ‘seeing quality and scheluleroquieners. The gery wil also ‘are Sci pre ayers Sra) LHCEA learned ore proce manageent lessons tron i suaentl ‘a wih he Ya bg ining tow engage progam mamas in ‘eelegy yrojeteand parse. Y2K vasa do-ordiesuton, bt {Ghrstors bape to ul onthe conidene rstredby sucostiiy Ace wih eile ‘Weve wonthowar anf now if bick o practi. TRereare 1 of computing otis tool with" Christoph spe "When you cn xls Sport for prot ht real ecae he sais) the bases eed, ‘henyou have amuch biter cnaoe of eing seen keto nk ‘net takingthme woo eHow