Case Study

Paragon Helps CMS Modernize Claims Processing

Paragon Helps CMS Modernize Claims Processing

Healthcare Reform PARAGON HELPS CMS MODERNIZE CLAIMS PROCESSING CLIENT OVERVIEW As the largest health care purchaser in the world, the Centers for Medicare and Medicaid Services (CMS) is expected to provide leadership in achieving the goals of reducing cost, improving health out- comes and increasing access to care. CMS, along with its state partners, provides health insurance for more than 100 million Americans, with outlays estimated at nearly $840 billion in 2011. Because its programs fund so much health care, its role reaches far beyond simply paying bills. CMS estab- lishes payment methods, quality measures and certification requirements, coverage policies, research priorities, and direction for innovation in health care delivery. BUSINESS CHALLENGE When the United Stat

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