pays off with savings, preventative care

Two prevailing government trends converged in the making of the Centers for Medicare and Medicaid Services faced an increasingly tech-friendly populace — and, like most agencies, it needed to cut costs. 

The website, which saw a significant upgrade in 2010, provides a self-service portal for some 13 million registered users. Those users tap for claims information and general information about the Medicare program. Prior to this online resource, beneficiaries would typically call a customer service representative through the 1-800-MEDICARE system.

“Clearly, the baby boomer generation is comfortable with technology, and as they age into Medicare eligibility, their expectations for online customer service and access to information will increase,” said Joseph Kuchler, a CMS spokesman. “For beneficiaries, and may be viewed as the self-service components of 1-800-MEDICARE."

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The online option seems to be winning over users. A CMS budget document projects 427 million page views in fiscal 2012.

In addition to helping users get the information they need, the self-service approach also delivers savings. That’s because beneficiaries can perform online many of the same activities as a customer services rep. The resulting reduction in cost per contact has generated more than $55 million in cost savings.

But aims to save money in a broader sense. For example, the online tool lets beneficiaries plan for certain types of visits. CMS several years ago developed an alert system to notify beneficiaries about preventive services covered by Medicare. Today, helps people stay up to date with mammograms, colonoscopies and other preventive services.

Since many preventive services are free of charge, “there will be no disincentive to avoid those appointments,” said Kuchler. “Better preventive care will reduce the overall cost of medical care.”

Another impact: the health of beneficiaries stands to improve with easier access to preventive care and other health information. A trusted source of information, Kuchler said, “can be useful to individuals who are interested in better understanding their conditions, or what they need to do to proactively manage their care.”

Tech integration

People and technology combined to drive the project. “The essential technology ingredient actually was a human element - the desire to develop online tools to help beneficiaries take charge of their interaction with Medicare,” Kuchler said. “The goal of integrating computer systems to share existing data with consumers is not new - but it needed to be leveraged for our internal systems, and then made available to beneficiaries.” ties into CMS enterprise applications. The website’s interface is developed on Microsoft’s .NET platform and taps Medicare’s Siebel backend. In 2002, CMS tapped Siebel Systems -- now part of Oracle -- for customer relationship management software.

Siebel software now supports both the self-service portal and CMS’ Next Generation Desktop application, which provides call-center automation. This deployment method provides consistent support to beneficiaries, whether they obtain Medicare information on the phone or online.

The .NET development environment, which supports Web, XML and interoperability standards, opens opportunities for personalization, customization and integration across CMS websites and with agency enterprise systems. In a nod to integration, the and sites are linked together so users can access information in one online session, as opposed to switching between the two sites.

Kulcher said the technology lets act as a single source of Medicare information about a beneficiary’s past services, through the claims history. Users can also access information they enter on their own -- allergies, medications and favorite pharmacies, for instance.

CMS technology strategy involves Web 2.0 components such as RSS feeds, podcasting, webinars, mobile-device support, Google mashups, interactive FAQs and Web Services for data sharing. Data visualization tools such as interactive charts and star ratings let beneficiaries compare Medicare plans and providers.

Looking ahead

CMS credits a small team of communications and operations staff as making the difference in executing the project and driving it forward. “These individuals spend their time learning about, and trying to meet beneficiary wants and needs,” Kuchler explained.

Overall, the project involved a collaboration of various agency groups and different skill sets. “We have ... had the opportunity to work with other components in the agency, which has broadened our understanding of communications, outreach, website design and the like,” Kuchler said.

External contractors back CMS’ in-house resources, contributing technical expertise to In 2010, CMS awarded a $73.2 million contract to CGI Federal to continue the modernization, application management, and maintenance of the, and websites.

CGI has been working with CMS to evolve its websites, the company reported. CGI cited Hospital Compare and Nursing Home Compare tools that pull together geographical data from Google Maps and health care provider quality-of-care information. The combination aims to help users locate and assess nearby health care providers.

CMS last year also pursued a redesign of, emphasizing user personalization, increased information access, and the ability to help beneficiaries make informed health care decisions. The redesign also focused on streamlining the website’s functionality to boost ease of use. Functional tabs were reduced from 12 to five, simplifying the information architecture.

CMS also added a "Blue Button" feature into that lets Medicare beneficiaries download their personal health information.

Looking ahead, CMS’ fiscal 2012 budget submission seeks funding to support “ongoing efforts to increase beneficiary self-service via online channels” and expanding services “to provide integrated health management capabilities.”

“One lesson that we have learned, as have others, is that ‘if you build it, they will come,’” Kuchler said. “The launch of was done with virtually no outreach, yet hundreds of thousands of beneficiaries found their way to it, and use it regularly.”

Another takeaway: Pay attention to your users. “We have also learned to listen to beneficiaries and their caregivers regarding their need and desire for access to their own information online -- versus the telephone,” Kuchler said.

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