Modernizing PECOS for CMS

Enhancement of Healthcare Enrollment Systems with Modern Technology

Background

Client

Centers for Medicare & Medicaid Services (CMS), Center for Program Integrity (CPI)

Challenge

Modernize the Provider Enrollment Chain and Ownership System to reduce manual processing, improve the user experience, and support compliance with emerging healthcare programs.

Solution

Leveraging modern web frameworks, cloud migration, low-code platforms, and Agile methodologies, PECOS was redesigned as a scalable, user-centric, and enterprise-grade solution.

Outcome

Streamlined application processes, enhanced user satisfaction, reduced maintenance costs, and improved operational efficiency.

The Challenge

PECOS needed a total overhaul from a legacy, single-purpose system to a modernized, enterprise-wide resource for provider enrollments across Medicare, Medicaid, and emerging healthcare programs. The objectives were to minimize manual workflows, enhance customer experience, and process applications faster with compliance and scalability.

The Solution

IStream Solutions leveraged its deep expertise in Agile methodologies, cloud engineering, and low-code platforms to modernize PECOS

Modern Architectures

Leaned on Angular, Spring Boot, and J2EE toward a strong web application architecture.

Cloud Migration

Migrated PECOS to Azure and AWS for scalability, security, and cost-effectiveness.

Low Code

Used the Appian and Salesforce platforms to speed up deployment and customization of new features.

Human-Centered Design (HCD)

Focus on UX through intuitive workflows and modular interfaces.

Agile DevSecOps

Implemented agile practices, delivered iterative updates faster, and had quicker responses to user feedback.

Key Outcomes

Operational Efficiencies

Eliminated the need for manual processing by providers and staff, reducing administrative burdens.

Enhanced Experience

Customers' modernized and friendly interface improves satisfaction.

Operational Savings

Reduces maintenance expenses through the elimination of redundant systems and standardization of configurations.

Scalability

Enterprise platform scalable enough to sustain increasing enrollments across programs.

Security

Fortified authentication for Single Sign-On (SSO), and REST APIs.

Key Feature Delivered is as follows

AMS Application modernization: Based on modularity and micro-services, it became easy to combine and scale
HCD Principles: Applied across different applications to offer better accessibility along with user comfort
Automated Service: Automated business tasks such as data synchronization among systems and Inter-system communication.

Key Takeaways

Innovative Systems Integration: with modular, scalable applications based upon microservices and APIs for flexible data exchange.
Cross-Platform Competence: Migration and enhancement of systems on both AWS and Azure cloud platforms.
Streamlined User Experience: Redesigned workflows and UI designs based on low-code tools for ease of use and flexibility.

Technologies Used

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