How CMS’s eMedicare Data Store is Improving the Customer Experience

The Center for Medicare and Medicaid Services is personalizing and improving the Medicare beneficiary experience with an upcoming eMedicare customer data store called the Beneficiary Experience Data Analytics Platform (BEDAP).

BEDAP builds off of the agency’s eMedicare customer experience modernization initiative that began in 2018. Throughout the development of eMedicare, CMS officials identified how there was a need for a new data store for beneficiary data that would support an omni-channel and personalized experience.

Before developing BEDAP, however, CMS faced some challenges that informed the design of the data store platform. These involved the complexity of changing data sources and careful management within live customer service systems, as well as consistency within and between customer experience systems, noted CMS Deputy Director of Web & Emerging Technology Rachel Horvath during last week’s CMS Data Summit.

To avoid these issues, Horvath said her team approached the situation with stakeholder involvement.

“We wanted to work with all the stakeholders involved and make sure that the decisions that we were making were appropriate and targeted and allowed us to build our knowledge as we went, and also to bring in the data that we thought had the most value to the online consumer,” Horvath said.

While building BEDAP, CMS developed a vision for the data store, so that it would:

• Improve beneficiary experience across communication channels
• Integrate with applicable data sources to provide a full picture of Medicare beneficiary data
• Provide CMS with data to conduct targeted, accurate, quick outbound campaigns, email and more
• Provide data to other CMS beneficiary-facing products to help create personalized experiences
• Provide analytics and business intelligence capabilities to give stakeholders actionable insights on beneficiaries.

The changes that CMS made with eMedicare and BEDAP led to a variety of changes and improved tools for beneficiary and user engagement online. CMS Office of Communications Web & New Media Group Director Jonathan Booth outlined these improvements, starting with the Medicare Plan Finder.

“It’s been rewritten to a modern codebase, has an improved user experience, is more scalable and performant than the old tool,” Booth said. “We updated that data refresh frequency, which is a big theme throughout getting as close as we can to real-time data wherever it makes sense. … In the old tool, beneficiaries entered their drug data manually, and then the new Plan Finder, if you’re an authenticated user, if you’ve logged in, we will actually populate the drug list in the tool from your [prescription drug event] data.”

CMS also rolled out a Care Compare tool that replaced eight standalone quality compare tools that were facility specific, such as nursing homes or hospitals. The consolidated tool now provides a single, consistent interface for users to search across all care settings, Booth said. In the future, he hopes to enhance this tool with BEDAP to display facilities with claims data instead of requiring users to search for the facilities.

Earlier this year, CMS also created a consistent header for common navigation items on Medicare.gov. This includes public pages and tools, as well as personalized items.

“If you’re logged in, you’ll actually have elements in the navigation that are unique to you. So for example, my saved drugs, my saved pharmacies will be links that take you to your information in the Medicare.gov website, if you’ve got that account you’ve logged into,” Booth said.

To enhance the Medicare messaging center, CMS applied BEDAP to enable secure, personalized message delivery to authenticated beneficiaries using Medicare.gov. Booth said this allows CMS to deliver more targeted messages with specific calls to action across its beneficiaries based on data pulled from BEDAP.

BEDAP has also enhanced CMS’s outbound messaging capabilities. Booth said that by storing subscriber and account holder data in BEDAP, the Office of Communications’ Medicare email outreach team has been able to send wider targeted messages to segments of the Medicare population to educate them on key programs or opportunities that they may be eligible for.

“One very recent example is we did a huge outreach and push campaign around encouraging Medicare beneficiaries to get the vaccine for COVID-19, and we were able to do that by having all this data and having this system that could do those polls,” Booth said. “We’re able to track the open and click rates on those messages, so we’re actually able to see how impactful these messages are, that they’re getting to the people they need to, and that they are opening them, and using the data, and we use that data to improve on these and make sure we’re getting better on them over time.”

Booth highlighted that CMS is balancing data accessibility to improve services with data privacy and protection. With CMS’s Scalable Login System, for instance, accounts are proofed against beneficiary data to protect user accounts. In the future, Booth said he would like to load account data elements — such as email addresses — so that they are available on other eMedicare systems when needed.

The data store is contributing to improvements in users’ ability to pay premiums online. For instance, Booth said that beneficiaries can pay their Part B premiums through Medicare.gov using Pay.gov services with the recent updates, and users can also now see past transactions.

“We process hundreds of millions of dollars in transactions of those Part B premium payments, so lots of stuff that was otherwise happening through paper checks and things like that, so a huge amount of modernization and streamlining of processes there,” Booth said. “We’ve also found that the users of this service are very loyal, and this is actually the group that returns and gets authenticated on Medicare.gov more frequently than basically any other set of users.”