Delivering health care benefits

Perspecta / About us / Markets we serve / Health / Payer segment

Payer segment

Perspecta has partnered with the Centers for Medicare & Medicaid Services (CMS) since 1966, providing Medicare solutions to increase access and improve quality health care for more than 50 million beneficiaries nationwide. We maintain an unwavering commitment to help CMS achieve its future goals with support and engagement from our entire Perspecta team.

What we do:

Application development, maintenance and modernization

Perspecta provides technology-enabled business rules used to process roughly 220 million Part A and one billion Part B claims respectively for Medicare beneficiaries annually. We are collaborating with CMS, CMS stakeholders and the U.S. Digital Service to modernize CMS’ Shared Systems and build digital services and products that serve CMS’s modernization goals, and provide real value to providers, beneficiaries, Medicare Administrative Contractors and other CMS stakeholders.

Analytics and data services 

Perspecta provides data engineering services (e.g. data extract, transform, and load , data application programming interface, virtual data mart, data modeling, data query assistance support, business intelligence support and data validation) for the CMS Integrated Data Repository (IDR). The IDR is the centerpiece of CMS’ Enterprise Data Warehouse Strategy. The IDR responds to the agency’s critical need to have an integrated data environment that contains Medicaid Statistical Information and Medicare claims, beneficiary, provider and plan data. The underlying technology of the IDR is an integrated Hadoop and Teradata Enterprise Data Warehouse, supporting massive volumes of data associated with CMS’ program benefits.

Cloud computing and infrastructure

Perspecta processes approximately 665 million Medicare Part A and Part B insurance claims annually for Medicare hospital, health care providers, and durable medical equipment (DME) claims nationally—approximately 54 percent of the A and B workload which includes 100 percent of the DME workload.

Perspecta also provides hosting services to support data center hosting for all nine common working file hosts, the pre-payment validation and authorization claims processing system for Medicare Part A, Part B, and DME prosthetics, orthotics and supplies claims processing systems.

Why it's important:

CMS is the single largest payer for health care in the United States. Working with them to provide innovative technology to support patient-centered care empowers patients to work with their doctors using meaningful information about both the quality and cost of health care options, promoting active health care consumers.