Cision PR Newswire
CNSI Awarded 5-Year Contract by CMS to Operate and Advance its Medicare Advantage Encounter Data Processing System
News provided byCNSI
Jul 25, 2022, 7:56 AM ET
MCLEAN, Va., July 25, 2022 /PRNewswire/ -- CNSI, a leading provider of innovative healthcare technology products and solutions, announced today it has been awarded a new five-year contract from the Centers for Medicare and Medicaid Services (CMS) to continue operating, maintaining, and supporting CMS' Encounter Data Processing System (EDPS) for Medicare Advantage (Part C) claims. The contract extends CNSI's decade of work with CMS to modernize, scale, and support its EDPS as enrollment in Medicare Advantage plans continues to increase over traditional Medicare.
"The successes we have achieved with the EDPS program over the last 10 years demonstrate our commitment to anticipating and responding to our clients' program needs and providing solutions and value as a true trusted partner," said Todd Stottlemyer, CEO, CNSI. "We are honored to be recognized for the success of that work with a new contract opportunity that will allow us to further enhance and strengthen the CMS EDPS program."
Encounter data contain the records of health care services provided to Medicare beneficiaries enrolled in managed care plans, known as Medicare Advantage. CMS collects and analyzes the data contained in the billed claims providers submit to Medicare Advantage organizations (MAO) to determine appropriate payment for MAO reimbursements.The EDPS automates the collection and analysis process to ensure timely payment resolution for tens of millions of encounters submitted each week.
CNSI began work on the CMS EDPS in 2012 and was awarded a five-year prime contract in 2017 to further modernize the existing system. Since then, CNSI completed migration of the EDPS to the AWS cloud, enabling the system to efficiently process over 1 billion encounters per year while also eliminating the encounter backlog. Additional modifications to optimize the EDPS have enabled the system to maintain 100% availability with near zero production defects and resulted in a 40% reduction in the program's AWS infrastructure costs. Today, the EDPS is capable of processing up to 2 billion encounters per year.
According to the 2022 Medicare Advantage Competitive Enrollment Report, Medicare Advantage programs now account for 45% of all Medicare enrollment, with about 28 million program participants. The report projects those enrollments to increase to 50% of all Medicare enrollment by 2025.
CNSI delivers a broad range of health information technology enterprise solutions and customizable products to a diverse base of state and federal agencies in the United States. CNSI aligns, builds, and manages innovative, high-quality, cost-effective solutions that help clients achieve their mission, enhance business performance, reduce costs, and improve the health of individuals and communities. Headquartered in McLean, Virginia, CNSI employs a world-class team of technologists, program managers, and subject matter experts with large-scale, mission-critical information technology implementation experience. Learn more at www.cns-inc.com.