Development of Automated System Enables Care Facilities to Meet CMS Requirements

Client’s Challenge

Multi-phase Development of Assessment Tool

A healthcare client needed a technology solution to automate the submission of PASSR reports by care facilities to meet requirements dictated by The Centers for Medicare and Medicaid Services. Our client had contracts with multiple states to coordinate the PASSR process, but it was labor-intensive and difficult to scale nationally.

Our Solution

Product Strategy and Execution

Our team provided business strategy, discovery interviews, requirements gathering, and application development for the complex multi-tenant assessment tool.

Value Realized

Complex, Scalable Custom Application

Our client successfully launched and marketed a Level I Assessment tool designed to handle complex clinical review and escalation processes and enable providers to maintain high quality outcome standards.  The success of this tool led to an acquisition of our client by an NYSE corporation that saw the potential to leverage the tool for other healthcare reporting processes.

Project Details

The Centers for Medicare and Medicaid Systems (CMS) introduced new PASRR audit policies and processes. Our client had contracts with multiple states to coordinate PASSR data collection and wanted to improve margins by automating a labor-intensive process. A multi-tenant tool would enable our client to configure functionality to meet requirements in different states and differentiate the company from competitors.

Our client’s existing system required them to manage each state contract in separate, custom client-server-based applications. This resulted in longer implementation timelines, higher complexity, and more resource-intensive maintenance for their team, limiting its capacity for scaling to a larger market.

InfoWorks provided expertise at each project stage, helping our client accelerate timelines and successfully launch the application.

During the first phase, our team performed discovery interviews, market analysis, and presented viable business models. The analysis included a compelling products-services vision along with three business models for taking that vision to market. Deliverables included a market opportunity summary, a competitive landscape assessment with potential threats, and a business model comparison for the three business models.

After documenting their current business processes and the functional and technical requirements for the application, we created a roadmap for developing the platform. These requirements included a complicated clinical review process, a security role-based matrix, and defined screen, non-screen, and administrative configurations.

Next, our team designed a sophisticated architecture to develop a configurable .NET web-based platform for transitions of care, beginning with the PASRR Level I assessment. We were able to meet their goal of releasing an MVP solution with built-in contract configuration settings within a short timeframe.

Our analysis gave them the confidence to move forward with phase II. InfoWorks supplied a dedicated team of development, quality assurance, HIPAA compliance, and project management experts for the build-out of the multi-tenant web-based tool that would streamline our client’s operations and scale as needed.

To prevent schedule delays, phase III of this project occurred in parallel with Phase II. It consisted of building Level of Care functionality into the application to satisfy a state contract agreement our client had entered into. The Level of Care functionality would equip the state to prevent costly admissions to Medicaid-certified nursing facilities and help ensure the most vulnerable individuals receive the right care in the right setting at the right time.

The success of the application ultimately led to the acquisition of our client by a NYSE company that continues to utilize the tool for PASSR and for other processes with their healthcare clients across the country.

Functionalities of the application include:

  • Keeps clients in compliance with CMS.
  • Delivers the most knowledgeable clinical expertise in the industry for individuals with disabilities.
  • Offers timely, independent, accurate screenings and evaluations.
  • Develops individualized recommendations and notifies all pertinent parties.
  • Designs state-specific, user-friendly, automated Level I, Level II, and Level of Care web-based systems that expedite reviews and reduce delays for care facility admissions.
  • Generates data and customized reports 24/7 that help the client manage their daily PASRR program needs with real-time results and program oversight.
  • Provides the information, data, and consulting expertise to help states develop strategic plans and initiatives for affiliated long-term care services.

Could your next project benefit from our specialized expertise? Contact us today.