Strategies and Priorities for Information Technology at the Centers for Medicare and Medicaid Services by National Research Council

Author:National Research Council
Language: eng
Format: epub
Tags: Health and Medicine: Healthcare and Quality
ISBN: 9780309221979
Publisher: The National Academies Press
Published: 2012-12-15T00:00:00+00:00

One of the largest agencies within the Department of Health and Human Services, CMS has more than 4,000 federal employees and approximately 80,000 external contractors organized into 6 major centers, 18 operating offices and consortia, and 10 regional offices across the country (Box 4.2).

The most recent enterprise-wide organizational restructuring of the agency occurred in 2001, when the agency changed its name from the Health Care Financing Administration to the current Centers for Medicare and Medicaid Services and reorganized into three centers reflecting the agency’s major lines of business: Medicare Management, Beneficiary Choices, and Medicaid and State Operations.5 In 2003, the most significant legislative change to Medicare (the Medicare Modernization Act, or MMA)6 was signed into law, adding a new outpatient prescription drug benefit and making many other important changes to the program. Figure 4.1 shows the CMS organizational chart at the time of this writing, including the three additional centers introduced since 2001.

Information Services and Information Technology in CMS

Although CMS has experienced significant organizational change over the years, information services and information technology have not been fully consolidated into an enterprise-wide operation. The lead office for IT is the Office of Information Services (OIS), headed by a director who also serves as the agency’s chief information officer. The OIS is organized into several units, including enterprise data, business applications management, information services design and development, an enterprise data center, an enterprise architecture and strategy group, consumer information and insurance systems, and resource and acquisition management. The Office of the Chief Information Security Officer is also part of the Office of Information Services. OIS’s main responsibility is to serve as the focal point for planning, organizing, and coordinating all aspects of the agency-wide information resource management program and to ensure the effective management of the agency’s IT, including information systems and resources. The office also serves as the lead for developing, maintaining, and enforcing the agency’s information architecture, policies, standards, and practices in all areas of IT (Box 4.3). Nevertheless, the committee’s impression is that there is still significant fragmentation of resources (human, technical, financial), and cross-program coordination and collaboration are less than ideal.

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