Data Powers CMS's Mission Amid COVID-19 Pandemic

Data Powers CMS's Mission Amid COVID-19 Pandemic

Policies and decision-making at the agency are increasingly involving the value of data.

The U.S. public has leaned into the Centers for Medicare and Medicaid Services heavily for health care support this past year amid the COVID-19 pandemic, and in turn CMS has leaned into data to provide better aid back to the people it serves.

Officials from CMS spoke at AFCEA’s CMS Day last week, highlighting ways in which COVID-19 has particularly pushed their organization to innovate and deliver on mission in new ways this past year. Amid that work, data has been a key guider in helping CMS understand where to bolster health care aid and information amid pitfalls the pandemic created.

Real-time data helped the agency understand early on that children were missing routine vaccinations and primary care check-ups, noted Deputy Director for Medicaid and CHIP Karen Shields. Her office used that data to act accordingly and help inform policy decisions.

“The data show that … rates for vaccinations, primary care and preventive services among children in both Medicaid and CHIP steeply declined, and we were in a position to provide that information kind of right before school started in August to form and help influence some of the policies related to balancing risk versus impact for some of the decisions that were made right before school,” Shields said.

Data has also helped CMS realize the efficacy of telehealth. In CMS’s January COVID-19 data report, CMS found that the percentage of beneficiaries who are receiving services through telehealth has spiked, and this information has informed how telehealth has created a continuity of care throughout the pandemic.

Amid changing policies and tides throughout the pandemic, data helped CMS’s Center for Clinical Standards and Quality ensure that policy and operations were running smoothly. Deputy Director Jeneen Iwugo said her team was using data to see the ripple effect of public health policy daily throughout the pandemic.

“We had to become much more flexible in the tools that we use to elicit the data from the systems where it resides and then just perfect it at lightning speed,” Iwugo said.

Iwugo added that data has been useful in breaking down silos to achieve that speed and cross-pollination.

“We definitely saw that in the midst of setting our policy priorities, when the rates of both COVID inspections and testing were going up and down, the impact that our policies had on people’s ability to respond was quite tremendous,” Iwugo said. “We are still looking at the silos that exists within our organization and using data to break those down, so not just more collaboration, but cross-pollination of data across the different areas of our center ... Policy is working in close coordination with operations.”

The amount of data CMS is receiving and managing is only growing, so being able to scale up internal capabilities around data has been another key area to help the agency continue its mission amid this past year. CMS CTO George Linares said that with the influx of beneficiaries this past year especially, the flow of data isn’t getting any smaller, so he’s looking to take advantage of industry’s technological advancements to make accessibility to data much easier.

“[Industry tools] can manage those constraints that we had in the past where you had a box, a server — you were constrained by what you can do, index inside that box, in terms of memory and compute power and things like that,” Linares said. 

Linares said that if he can remove the constraints of legacy capabilities and increase access to data, he can allow for experimentation, analysis and greater ability to use the data that CMS has and continues to gather. 

As CMS is currently using and continuing to build up data-driven policies and capabilities, CMS Deputy Director for Operations Center for Consumer Information and Insurance Oversight Jeff Grant is just getting this past year’s worth of information from insurance companies’ remote servers on claims data, which will form a more complete picture of how COVID-19 impacted insurance companies and health care delivery in 2020.

“A lot of doctors' offices were shut down for a few months and not seeing patients, so medical costs for insurance companies actually went down, and our big questions are more: What is going to happen to medical trends over the next couple of years? What’s that going to mean for prices for insurance?” Grant said. “These are all difficult questions to answer. We’re still kind of waiting to get the data to do that."