Centers for Medicare and Medicaid Services
How CVPS supports CMS:
With our Eligibility & Beneficiary Services
We track the universe of all Medicare beneficiaries and act as the official hub for data exchange on beneficiaries.
We determine eligibility of citizens who seek coverage through the Obamacare marketplace website.
We modernize and integrate many disparate systems and functions to upgrade the user interface.
With our Program Integrity (Fraud) Services
We provide predictive modeling tools used to review and analyze Medicare claims for potential fraud.
We process and analyze approximately 4.5 million claims a day for fraudulent patterns and incidences.
We've provided solutions that produce a 10 to 1 Return on Investment (ROI) and prevented loss of $820M in its first 3 years of implementation.
Through our Pay for Performance (P4PP) Solution
We support the delivery of quality care through the promotion of communication and coordination via Electronic Health Records (EHRs).
We've developed and implemented payment modifiers for physicians based on quality and resource usage algorithms.
We support the implementation and evaluation of alternative payment models to the traditional Fee-For-Service approach.