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Centers for Medicare and Medicaid Services

Teradata and CMS: Fighting Medicare and Medicaid Fraud

In May 2005, CMS officials evaluated their options and selected a Teradata system as the platform for the Integrated Data Repository (IDR) located in CMS headquarters. IDR enables CMS to better organize its data by beneficiary and by provider into one repository instead of separate regional systems. Because CMS and its contractors can now evaluate data nationally instead of just regionally, it provides better opportunities for identifying fraudulent claims and abuse.

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"Organizations that are willing to exercise thought leadership at an executive level and invest in a centralized, enterprise-class intelligence environment have shown they benefit in the mega-millions of dollars — not only in return on investment but also in lower total cost of ownership."

Gary Christoph, Chief Informatics Officer for Teradata Government Systems and former CIO, CMS, 2007

CMS annually disseminates more data than any other federal agency or private-sector company to researchers, policy groups, associations, medical groups and private citizens. It administers the Medicare program and works in partnership with states to administer Medicaid, the State Children's Health Insurance Program and health insurance portability standards.

The Teradata environment at CMS comprises the largest volume of healthcare-related data files in the world. A Teradata Professional Services team assists CMS in establishing, supporting and governing the enterprise data warehouse from Teradata, while a separate Teradata Customer Services group provides business-critical maintenance, customer education, installation and other services.

CMS' Integrated Data Repository (IDR) enables the agency to better organize its data by beneficiary and by provider into one repository instead of separate regional systems. In addition to helping eliminate activities of fraud, waste and abuse, the Teradata solution offers CMS a host of other benefits, including the abilities to:

  • Quickly add new data and applications
  • Easily accommodate new requirements
  • Address additional Health Insurance Portability and Accountability Act (HIPAA) data protections
  • Perform in-depth analysis such as medical and pharmaceutical trend analysis, accurate actuarial and underwriting analysis, predictive analysis and chronic-care improvement analysis
 

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Helping Insurers Manage Risk and Realize Rewards.
Find out how Teradata technology and expertise is helping CMS fight fraud and more.

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