Year: 2025
Type: article
Abstract: Healthcare organizations managing Medicare Advantage plans face increasing challenges in maintaining compliance with the Centers for Medicare & Medicaid Services (CMS) universe submission requirements. The transition from traditional manual processes to cloud-native solutions offers transformative opportunities for improving operational efficiency, data accuracy, and regulatory compliance. This technological evolution enables real-time monitoring, automated validation, and enhanced risk management capabilities while providing scalable infrastructure for future growth. The implementation of cloud-based compliance management systems demonstrates significant potential for reducing processing times, improving data quality, and ensuring continuous compliance monitoring across healthcare operations. The integration of advanced analytics, artificial intelligence, and machine learning capabilities further enhances the ability to predict and prevent compliance issues before they emerge. Modern cloud architectures support seamless integration with existing healthcare systems while maintaining strict security protocols and regulatory adherence, enabling organizations to focus on delivering quality patient care rather than managing complex compliance processes.
Author: Bandanawaz Mulla
Institution: Visvesvaraya Technological University
Language: English
Subfield: Health Information Management
Field: Health Professions
Domain: Health Sciences
Open Access status: hybrid
OpenAlex ID: W4410464151