To the relief of some health insurers and the frustration of other payers, Centers for Medicare and Medicaid Services (CMS) recently announced the option for healthcare insurers to use the Amazon Web Services (AWS) cloud to host edge server data reporting for CMS reinsurance (RI) and risk adjustment (RA) calculations. Edge server data submission is required of Affordable Care Act (ACA, also known as Obamacare) healthcare plans. The Advalent edge server solution, Advalent 3R Edge Plus, supports the use of Amazon EDGE server.
When insurers were told of the Amazon Web Services option called Amazon EDGE, the news was said to have met with resignation and surprise by some payers, frustrating those who had already invested in costly hardware infrastructure to host their edge server solutions, reported CNBC. The hardware for a small plan is reported to cost $10,000 while a larger plan might pay $50,000 for the necessary on-premise edge server hardware. A significant advantage of Amazon EDGE server hosting is lower costs. A Wired magazine article explained another advantage of the Amazon EDGE solution on Amazon Web Services – reliability and uptime. Hosting parts of HealthCare.gov on Amazon Web Services is expected to increase reliability and reduce outages during peak periods. Amazon Web Services passed the U.S. government’s rigorous security requirements for HealthCare.gov and edge servers. Amazon offers standard business associate agreement (BAA) and contracting terms that address HIPAA. The Amazon EDGE server option will provide a dedicated server to manage HIPAA-protected health information, says CMS. Amazon provides additional helpful guidance on recommended security best practices for its clients. CMS materials from May 28 unveiling the Amazon EDGE server option say the provisioning process is straightforward. Issuers will purchase an Amazon account that includes the operating system and download the EDGE application. The cost will vary by size of plan, but is expected to range from:
- $300-600 for a small plan
- $600-1000 for a medium plan
- $1000-2000 for a large plan
In addition to lower costs, CMS says the Amazon EDGE approach offers the following benefits:
- Minimizes customized set-up during provisioning and improves efficiencies
- Provides flexible capacity and scalability and a standardized platform for deployment
- Offers secured access supported through Hypertext Transfer Protocol Secure (HTTPS)
The cloud-based, turnkey, health insurance exchange (HIX) edge server platform from Advalent called 3R Edge Plus is ready-made for data submission to CMS in the cloud, whether the edge server is hosted by Advalent, by Amazon Web Services, or as a physical or virtual server on the customer’s own hardware. Advalent 3R Edge Plus is ready today with all the Accountable Care Act (ACA) and Health and Human Services (HHS) data submission, risk adjustment and reinsurance reporting rules for HIX plans built-in. 3R Edge Plus allows insurers to comply quickly with HHS requirements for risk-based data submission and achieve a complete and accurate risk score analysis.
Advalent offers an efficient, robust and scalable model for delivery of healthcare IT via a turnkey, subscription-based solution. Our Platform-as-a-Service (PaaS) solution supports the agility and adaptability needed to address always-changing healthcare business requirements for payers and providers – including the option of using Amazon Web Services (AWS) for CMS risk adjustment and reinsurance data reporting. Unlike other HIX edge server solutions, the modular Platform-as-a-Service (PaaS) approach of Advalent ensures you can deploy our healthcare IT solutions quickly and easily – on a common platform with a common user interface and using open standards. The Advalent platform encompasses multiple capabilities, including Encounter Data Processing System (EDPS) reporting, edge server data submission, custom reporting solutions, big data analytics and advanced analytics, and a solution for Accountable Care Organization (ACOs). Advalent offers a discount to help small healthcare plans get started with CMS reporting: 3R Edge Plus data submission is free for the first 1000 members. Risk adjustment and reinsurance reporting is easier than you could have imagined. Free yourself from high upfront IT implementation costs: Sign up for a demo and free trial today and experience the Advalent difference for yourself.