Insights on NHA’s Recent CMMI Appraisal

by Neil Hoosier

Founder and CEO, Neil Hoosier & Associates

Neil Hoosier and Associates, Inc. (NHA) was again rated at Capability Maturity Model Integration (CMMI®) Maturity Level 3 for Services. This assessment confirms that our Centers for Medicare & Medicaid Services (CMS) Medicare Secondary Payer Integration Contractor (MSPIC) and Evaluation and Oversight (E&O) contracts and support staff have established sets of standard processes and improve them over time.

Having an outside entity confirm the quality of your company’s processes and procedures is important. However, the real test comes in applying what you’ve created to actual project work. NHA has been successfully doing so on its contracts, using the application of CMMI best practices as a tool for Contract Performance Optimization, one of our key capabilities. NHA looks for areas of improvement in tools, processes, and procedures that address the problems that keep a contract from reaching peak performance. We start by listening to contract stakeholders, then come up with tailored solutions.

For example, under MSPIC, CMS needed assistance twice transitioning contractors into the Coordination of Benefits and Recovery (COB&R) program. First, NHA facilitated the Commercial Repayment Center’s (CRC’s) transition by reviewing their CMS deliverables and Standard Operating Procedures (SOPs); providing training on Medicare, the recovery process, and the Benefits Coordination and Recovery System (BCRS) application; and managing the data transition from the incumbent into the COB&R applications.

Then, during the Workers’ Compensation Review Contractor (WCRC) transition, NHA worked closely with the new contractor to incorporate them into the COB&R processes and activities and delivered a new Workers Compensation Case Control System (WCCCS) training which assisted them with the development of their SOPs. More recently, NHA helped the WCRC obtain an Agency Authority to Operate (ATO) for their cloud-hosted workload tracking system.

In both cases, NHA’s work helped the incoming contractors assimilate into the COB&R program so they could more quickly contribute to the program, which saves the Medicare program over $9 billion dollars per year by recovering funds incorrectly paid for medical claims and preventing Medicare from paying for claims that should be covered by other programs. That’s quite an impact!

In the coming months, I’ll discuss other examples of how NHA is optimizing contracts’ performance and bringing quality improvements that make a measurable improvement to government programs.

If you are interested in finding out more about how NHA’s commitment to CMMI ideals and to contract performance optimization is helping CMS and other government agencies, please see our website at:

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