Cogent People Stakes Out CMS’s Path to the Future

In summer 2021, Cogent People joined with Noblis, another trusted vendor partner of CMS, to kick off the Data 2025 Initiative.

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The Office of Information Technology (OIT) is the leading component within the Centers for Medicare & Medicaid Services (CMS) that is responsible for enterprise architecture, resource planning, and IT implementation for CMS’s 22 components and 130 million beneficiaries. Having personally worked with CMS at the highest levels for many years, Cogent People’s principals were honored when OIT and CMS sought their guidance to develop the first truly enterprise-wide Data Strategy. As with other federal agencies, CMS has realized that it needs to improve on many dimensionsdata visibility, data accessibility, understanding, and interoperability of data assets within its extremely complex and highly fragmented data ecosystem.

As the component driving strategic IT direction for the largest agency for healthcare within the United States, OIT is responsible for providing thought leadership to the C-Suite of CMS executives, reporting directly to the Chief Operating Officer. From his perch at OIT, Deputy Director Bobby Saxon, realized that, without a holistic, full-spectrum approach to data maturity, OIT risked failing in its core advisory role. In 2020 and beyond, there are multiple trends that are sweeping across the industry, including Big Data, Artificial Intelligence (AI), Machine Learning (ML), and, of course, the general transition from on-premises to cloud-native and from commercial to open-source solutions. Without an overall direction, which takes all these factors into account, OIT and CMS seemed destined to repeat many of the costly, innovation-stifling mistakes of the past. Thus, the Data 2025 project was conceived, and Cogent People was selected to lead the effort that would set the guideposts for the enterprise to follow.

CMS is challenged with issues of data quality, access, and reliability, just like many of the largest enterprises in the country, whether public or private sector, regardless of industry. Data flows through a byzantine structure of vendors and products, which naturally leads to various deficiencies. A wide range of CMS systems from actual mainframes with ancient tape drives to cloud-native products coexist simultaneously in the same data ecosystem. Each is responsible for its own scope of operations; each product or system ingests and transforms data from various upstream providers, relying on a mix of proprietary, commercial off the shelf (COTS), and open-source systems to hand off data as a product for business intelligence, evidence-based policymaking, or other end user priorities. The predictable result is a fragile, brittle system, the analysis of which leads to recommendations for increasing end user productivity, reducing redundancy and otherwise breaking out of obsolete patterns of implementation.

In summer 2021, Cogent People joined with Noblis, another trusted vendor partner of CMS, to kick off the Data 2025 Initiative. Key highlights of the project include:

Review of Landscape and Survey Analysis

One of the first tasks we performed was to conduct a comprehensive review of CMS’s peers in the federal space. What had other large organizations with millions of stakeholders and billions of dollars in budget been up to all these years? A simple enough question, some would say. We were able to collaborate with peers in other departments, such as Department of Defense (DoD), to access and review similar efforts. We learned that even the largest, most sophisticated agencies were often stumbling around in the dark. The nature of the challenge is daunting to even the most richly resourced organizations. CMS OIT, being relatively small in manpower and faced with feudal and territory issues, had some ground to make up vis-à-vis other agencies, but, by no means, were our peers faring that much better.

We needed the right hand to know what the left hand was doing. We also needed to know which fingers of which hand were laying a foundation for a future based on best practices. Where could a center for excellence be planted and take root? To this end, the Cogent People team identified and conducted hundreds of hours of one-on-one interviews, both formal and informal, with dozens of thought leaders throughout the wider CMS enterprise. Naturally, some individuals had resources or experience with these questions, depending on the role or idiosyncrasies of leadership. We did not wish to make assumptions that would later prove to be unfounded, so we performed baseline-establishing surveys, collected objective, quantifiable data and captured this to a Salesforce Tableau site for later use in the project. The feedback from open-ended questions would later prove invaluable to our thinking.

A Pop-Up Market for Ideas

Over a period of three months in early 2021, the Cogent People led a series of six live workshops centered around three of the prevailing themes from the previously occurring interviews. Each workshop had approximately two dozen live participants for 90 minutes to 2 hours in time.

In the midst of the storm that was COVID-19, we employed the collaboration software Mural to focus everyone’s attention on the prevailing themes, conduct live Q&A, and otherwise foster participation in the process. We received overwhelmingly positive feedback about our openness and willingness to listen, confirming that the department and division level leaders appreciated our effort to build a new forum for collaboration. Despite legitimate concerns about protecting turf, there is an undeniable appetite for enterprise-wide problem solving. With virtually no exception, federal employees and contractors truly want to innovate—they just need a little support.

Toward a Positive Sum Game

A relatively short, finite project of modest cost, the Data 2025 Initiative was designed to test the waters. Leadership in OIT and out of the Office of the Chief Operating Officer (COO) needed hard evidence that would confirm that, indeed, there are areas for cooperation across the CMS components and that there is bottom-up support. This is true regardless of the party in control of the White House. We know from previous work that cooperation requires investment in a support structure that persists over the years and is sustainable across long budgetary and product cycles.

The Data 2025 project was also designed from the beginning to be nonthreatening. There would be no talk of OIT taking jealously guarded resources from one group to give it to another, nor would there be an air of creating winners or losers. Instead, Data 2025 was to lay the groundwork for a future investment in workforce and money that would lead to net-net gains across the enterprise

The contract for the Data 2025 Initiative ended in Spring 2021, but the work lives on. As our final deliverable, we collaborated with some of the most innovative visionaries at CMS to craft a comprehensive strategy paper. As with all this Cogent People, it was written to the exacting needs of the customer. It goes without saying that it was presented on time and on budget. When the moment arrives and our recommendations progress from paper to reality, Cogent People will be there with the customer every step of the way. Even now, Cogent People continues discussion with CMS leadership on these topics and has benefitted from follow-on contracts such as the MIDAS Data Catalog that were directly related to the work performed in the scope of this relatively small contract.

The progression to enterprise-wide Data Maturity is a journey, not a single event. At Cogent People, we foster a culture of innovation. We are one of the few firms in the federal space that maintains a sufficient mix of thought leaders, architects, developers, and business analysts to do this type of work on demand. By “on demand,” we mean that you can have actionable deliverables in weeks or months, not years or decades.

Our diversity lets us tackle these types of projects, especially those that may have some degree of risk of failure. We are confident in our ability to work under uncertainty, because we know that we can deliver.