PECOS

Project Name

PECOS: Medicare Enrollment

Role

UX Design

Visual Design

Branding

Date

05/20/2019

Overview

The Provider Enrollment, Chain, and Ownership System (PECOS) is used by healthcare providers and suppliers to enroll, update, and maintain their Medicare information with CMS (Centers for Medicare & Medicaid Services).

Problem statement

Working with an antiquated legacy system, doctors and office staff were losing valuable patient time managing separate applications to enroll across multiple practice locations as Medicare providers. Revalidation deadlines were frequently missed, causing practices to fall out of compliance. Additionally, the acceptance of paper applications further slowed the review and processing times.

Goal

A redesign of the Provider Enrollment, Chain, and Ownership System (PECOS), transforming how providers enroll in Medicare. CMS aimed to simplify the process by allowing providers to enroll in multiple states or update details across several enrollments through a single application. The initiative also sought to shift providers from paper submissions to a more efficient, online enrollment experience.

I collaborated closely with the client and conducted end-user interviews to uncover pain points and process gaps within the legacy system. This work offered a valuable opportunity to identify which data was most important for collection and reporting, as well as to explore data visualization approaches.

Clear design goals kept the team aligned and focused during Agile sprints, even when timelines left limited space for deep solutioning ahead of new feature requests.

Note: This project focused solely on design and requirements. Development is currently underway, and the new application has yet to launch.

Takeaways

• Providers wanted to have applications using pre-populated information tailored to them

• They wanted to view and manage all their information in one location

• Providers wanted one application that would update multiple enrollments

• MACs wanted simplified provider group management

• Ensuring information is accurate for each state is burdensome when physicians practices are constantly expanding

• Keeping documentation updated and readily available for periodic audits.

• Providers wanted reminders on the revalidation process

• Providers wanted to track the status of their applications in real-time

• Providers wanted the ability to view all letters and notifications in one place
  

User Research

Design & UX

Public Search Page

Provides a quick unauthenticated snapshot for MACs searching for providers. Once logged in, a provider's enrollment data becomes available.

Application Homepage

Allows providers to securely submit Medicare applications, and provides news, policy changes, and revalidation reminders.

Provider Dashboard

The dashboard provides a snapshot for a provider's current enrollment status, any pending actions or messages, and the option to begin a new enrollment. It also allows for documents and certifications needed as part of the revalidation process, in a central location.

Achievements

• 80+ unique page designs within 18 months

• 7 user interview sessions held with 29 participants

• Faster, error free form completion

• Simplified processing workflows for users

• Greater interoperability across programs

• Increased transparency for all provider enrollment across emerging programs

• Knowledge based articles for enrollment criteria