How CMS reduced its services cost by adapting
Sparx Systems Enterprise Architecture

The Centers for Medicare & Medicaid Services (CMS), a pivotal federal agency within the US Department of Health and Human Services, administers healthcare programs for millions of Americans.

The complexity and scale of CMS’s IT environment posed significant challenges, including decentralized architecture, disparate data sources, and difficulty aligning business and technical goals for strategic decision-making. This transformation not only enhanced efficiency but also led to substantial cost savings, ultimately benefiting the agency and the millions of Americans it serves.

This case study dives deep into how CMS adopted Sparx Systems Enterprise Architect (EA) to establish a centralized, data-driven enterprise architecture platform.

Listen to Senior Solution Architect Christine and her team of experts talk about how they addressed CMS’ business concerns with Sparx Systems tooling.

Enterprise Architecture Use Cases for CMS

Assess Health Legislation Impacts to CMS Business and IT Operations

A solution that enables CMS to evaluate the effects of health legislation on both business and IT operations.

Enable Real-Time IT Asset Management (System Census)

The platform must support real-time IT asset management, providing a comprehensive and up-to-date inventory of all systems within CMS. This centralized system census enhances visibility into the IT landscape, enabling more effective management and optimization of IT resources.

Provide Business Architecture Services

Facilitate the provision of business architecture services, aligning business objectives with IT capabilities. By creating a clear blueprint of the organization’s structure, processes, and systems, CMS can ensure that its business strategies are effectively supported by its IT infrastructure.

Facilitate Capital Planning and Investment Control (CPIC)

The platform aids in capital planning and investment control, ensuring that all IT investments are strategically aligned with the organization’s goals. Sparx EA provides tools for evaluating and prioritizing IT projects, optimizing resource allocation, and maximizing the return on investment.

Support Governance Boards for Decision-Making Capabilities

Sparx EA supports governance boards by providing comprehensive data visualizations and reports. These insights empower governance teams to make informed decisions, enhancing the overall strategic management of IT resources and ensuring alignment with organizational objectives.

Federal Reporting and Data Calls

The platform simplifies federal reporting and data calls, ensuring that CMS meets all reporting mandates efficiently. Sparx EA integrates data from various sources, providing accurate and timely information for federal reporting requirements.

Challenges and Drivers for Change

CMS encountered several critical issues within its IT architecture:

  • Decentralized Architecture: Each CMS department managed its own IT infrastructure, resulting in inconsistencies and inefficiencies.
  • Disparate Data Sources: Data was scattered across various systems, complicating efforts to achieve a comprehensive view of the IT environment.
  • Balancing Business and Technology: Aligning business objectives with technical requirements was a cumbersome process, hindering effective decision-making.
  • Reporting Requirements: Meeting the stringent reporting mandates of the Department of Health and Human Services was challenging.

These limitations impeded CMS’s ability to achieve optimal efficiency and transparency in its IT operations, necessitating a shift toward a centralized, data-driven architecture.

Sparx EA: A Solution for Centralized Architecture

CMS EA Strategic Use Cases

CMS selected Sparx EA as its enterprise architecture platform to address several strategic use cases:

By addressing these strategic use cases, Sparx EA has transformed CMS’s enterprise architecture, enhancing efficiency, transparency, and decision-making capabilities across the organization.

CMS Enterprise Data Analytics Repository (CEDAR)

The new architecture is centered around a cloud-based environment called “CEDAR,” which integrates several critical components:

  • Sparx EA: The core platform for enterprise architecture modeling.
  • Sparx Prolaborate: A collaborative workspace for stakeholders to access and share architecture information.
  • Pro Cloud Server: Enables secure cloud deployment of Sparx EA and Prolaborate.
  • API Tools: Facilitate data integration between Sparx EA and external systems.
  • Web Application: Provides a user-friendly interface for accessing and interacting with architecture data.

Implementation Process: CMS Enterprise Architecture and Tool Migration Journey

In June 2021, the Centers for Medicare & Medicaid Services (CMS) embarked on a significant journey to address the challenges posed by their existing Enterprise Architecture (EA) tool suite and methodology. Recognizing the need for a more efficient, cohesive, and data-driven approach, CMS initiated the migration to a new EA tool. This ERP tool migration approach was meticulously planned and executed across four major phases. Phase one involved conducting a comprehensive EA assessment to understand the current landscape. Phase two focused on documenting EA and tool requirements, ensuring all stakeholder needs were captured. Phase three entailed a thorough assessment of potential tools to identify the best fit for CMS’s needs. Finally, phase four saw the implementation of the selected tool and new methodology, bringing the vision of a centralized, efficient, and innovative EA platform to life.

Phase 1: Assessment (Understanding the Landscape)

This phase involved a thorough evaluation of the existing IT architecture, including hardware, software, applications, and data sources. The needs and requirements of various stakeholders across different CMS departments were identified.

Phase 2: Requirements Definition (Charting the Course)

Design workshops were conducted to define methodologies, data visualization approaches, and desired functionalities of the new architecture platform. Stakeholder input was crucial in establishing specific use cases for Sparx EA.

Phase 3: Tool Assessment (Selecting the Right Fit)

A comprehensive vendor assessment was carried out, evaluating various enterprise architecture tools against defined requirements. Sparx EA was selected due to its data-centric approach, out-of-the-box functionalities, and alignment with CMS’s needs.

Phase 4: Implementation (Bringing Vision to Life)

Sparx EA was successfully implemented within the CMS Cloud environment. Initial modeling capabilities were deployed, allowing for the creation of visual representations of the IT infrastructure.

Tool Assessment Approach

A critical phase in CMS’s implementation process was the tool assessment. This phase ensured they selected the most suitable Enterprise Architecture (EA) platform for their needs. The assessment followed a rigorous approach, which can be broken down into four key steps:

1. Requirements & Vendor Self-Assessment:

  • CMS meticulously defined their specific requirements for the EA platform. These requirements encompassed functionalities, data management capabilities, integration needs, and scalability considerations.
  • Potential vendors were provided with a detailed self-assessment questionnaire aligned with CMS’s defined requirements. This questionnaire helped CMS understand how each vendor’s platform addressed their specific needs and limitations.

2. License and Infrastructure Cost Analysis:

  • Beyond functionalities, CMS evaluated the total cost of ownership for each shortlisted platform. This included analyzing licensing fees, potential infrastructure upgrades required to support the platform, and ongoing maintenance costs.

3. Demonstration Script & Vendor Demo:

  • Based on the self-assessment and cost analysis, CMS shortlisted a select few vendors. These vendors were invited to participate in live demonstrations.
  • A pre-defined demonstration script was developed, outlining specific functionalities and scenarios each vendor needed to showcase. This ensured consistency and a fair evaluation across all vendors.

4. Consolidated Assessment:

  • Following the demonstrations, CMS conducted a comprehensive assessment. This assessment considered the vendor self-assessment responses, licensing and infrastructure cost analysis, and the live demonstrations.
  • A scoring matrix was potentially used to evaluate each vendor based on pre-defined criteria, ensuring objectivity and transparency in the selection process.

AWS Deployment for CMS Sparx Implementation

AWS Cloud Environment

The CMS AWS footprint is organized using a sub-organization structure, inheriting services from the main CMS Cloud account. This approach ensures consistency and streamlines management of resources across the organization.

VPC Architecture

The architecture utilizes Virtual Private Clouds (VPCs) with segregated subnets for development, testing, and production environments. The best security practices are followed, with the data subnet isolated behind application and web subnets to ensure data integrity and protection.

Availability Zones

While the current deployment resides in a single Availability Zone, communication mechanisms are established across other zones to ensure redundancy and high availability. This setup enhances the resilience of the CMS IT infrastructure.

Single Sign-On (SSO)

CMS provides Single Sign-On (SSO) functionality through Security Tokens, integrated with the Sparx platform. This integration simplifies user access and enhances security by leveraging existing authentication mechanisms.

Deployment Phases

The implementation process involved a collaborative design phase with the Sparx team, followed by development, testing, and production deployment phases. This structured approach ensured that all aspects of the deployment were meticulously planned and executed.

Security Considerations

Security scans were conducted, identifying eight findings. Collaboration with the Sparx team resolved six findings within 30 days, avoiding the need for a formal Memorandum of Understanding (MOU). The remaining two findings were addressed before the final deployment, ensuring a secure and compliant environment.

Compliance

The deployment adheres to Section 508 compliance standards for accessibility. A test plan was developed with the Sparx team, achieving a score of 75.13%. Efforts are ongoing to improve the score and establish an exemption for the Sparx EA Future Client application based on its visualization nature.

CEDAR – API Management Suite

The CEDAR API management suite is central to CMS’s IT infrastructure, positioned between two logical firewalls. The suite comprises three main components: the API Gateway, the Enterprise Service Bus (ESB), and the API portal.

API Portal

The API portal serves as a gateway for external developers to access information about the APIs published by CMS. Through this portal, developers can:

  • Learn about available APIs.
  • View input and output signatures.
  • Read detailed descriptions and usage instructions.


This facilitates external collaboration and integration by providing comprehensive information about CMS’s APIs.

API Gateway

The API Gateway is the primary entry point for all incoming API calls. It performs several critical functions:

  • Authentication and Authorization: Ensures that only authorized users can access the APIs.
  • Security Policies Enforcement: Applies and enforces security measures to protect the data.
  • Monitoring and Logging: Tracks API usage and performance.
  • Analytics: Provides insights into API usage patterns.
  • Throttling and Denial of Service Monitoring: Protects the system from overloads and attacks.


As the gatekeeper, the API Gateway ensures secure and efficient management of API traffic.

Enterprise Service Bus (ESB)

The ESB consists of the API runtime and the integration platform:

  • API Runtime: Where REST API code is deployed and executed.
  • Integration Platform: Supports various data intake methods (e.g., REST, SOAP, FTP) and includes tools for data transformation and database connectivity. This platform enables rapid API development and integration, allowing CMS to efficiently manage and manipulate data from multiple sources.

API Approach

Abstracting Complexity for Developers

Given that CMS API developers are not regular users of the Sparx EA system, a strategy was devised to abstract the complexity of the system. This involved a combination of the Sparx EA API, database stored procedures, and database views. Key elements of this approach include:

  • Wrapper APIs: Simplify interactions by handling login, token requests, data formatting, execution, and response checking.
  • Stored Procedures: Facilitate updates with descriptive names and clear data requirements, allowing developers to focus on their tasks without in-depth system knowledge.
  • Database Views: Provide intuitive access to data, making it easy for developers to locate and retrieve necessary information.


This approach enhances productivity and allows developers to focus on their core competencies, significantly reducing the learning curve and development time.

Benefits and Outcomes: A Transformation for the Better

The journey of implementing the new toolset at CMS has yielded significant benefits and transformative outcomes. Reflecting on the accomplishments over the past several months, several key achievements stand out:

  • Cost Savings: One of the most notable benefits is the substantial cost savings achieved. CMS reduced annual expenses by over $1 million, primarily through savings in licensing costs and contractor support. The ERP team was able to support the toolset under existing contracts, ensuring these savings are not just a one-time occurrence but recurring annually.
  • Pilot Setup Savings: ERP’s negotiation with Sparx to use their platform for setting up the pilot saved CMS approximately $105,000. This was a significant saving, as it eliminated the need to establish a separate platform for the pilot phase, leveraging the existing infrastructure instead.
  • Simplified Data Management: A significant improvement was the reduction in data complexity. By utilizing Sparx EA and a single, collaborative database, CMS moved away from the challenging environment of maintaining two separate databases. This transition to a single database for modeling and dashboarding has saved time and added reliability to the data presented.
  • Out-of-the-Box Configuration: The implementation focused on utilizing as much of the out-of-the-box configuration and standards as possible, minimizing customizations. This approach fits within the standard configuration and reduces the complexities and costs associated with heavy customizations, especially during upgrades.
  • Vendor Assessment Verification: Through this process, CMS learned the importance of verifying vendor self-assessment results. While vendor self-assessments were helpful during the review of several EA vendors, it was crucial to confirm that the functionalities claimed were current and not merely planned or requiring significant customizations. This ensured that the chosen solutions were both functional and cost-effective.
  • Enhanced Integration with API Gateway: Adding the API Gateway was another key component in ensuring the system’s proper functioning. Previously, the modeling and reporting databases struggled to stay in sync without the Gateway. The new design, supported by the CIO, integrated the EA tool with the governance intake system’s backend database, maintaining essential connections through developed APIs. This integration not only kept systems in sync but also provided greater flexibility in integrating new data sets.
  • Greater Flexibility and Reliability: The overall transformation has provided CMS with greater flexibility in integrating new data sets, supporting both the EA System and the governance intake system. This improved flexibility and reliability in data management and reporting processes have been crucial in maintaining the system’s integrity and supporting the organization’s evolving needs.

The transformation of CMS’s IT architecture with Sparx EA has proven to be a strategic success, enhancing efficiency, transparency, and decision-making capabilities. This centralized, data-driven approach serves as a model for other government agencies and large organizations facing similar challenges. The successful implementation of Sparx EA underscores the importance of adopting innovative solutions to manage complex IT environments and meet the evolving needs of stakeholders.