Automated data validation streamlines pharmaceutical’s CMS reporting

Client background

Novo Nordisk is a global pharmaceutical company known for its leadership in diabetes care and other chronic diseases. With a significant global footprint, the company operates across numerous markets and manages complex regulatory reporting requirements. 

The business challenge

Novo Nordisk identified an opportunity to enhance efficiency and improve data quality control in their process for complying with the Physician Payments Sunshine Act – which mandates transparency in transfers of value with healthcare providers by requiring pharmaceutical and medical device manufacturers to report payments to the Center for Medicare & Medicated Services (CMS) Open Payments platform.

The process for submitting detailed payment data to CMS was highly manual with data being collected from multiple sources, including manual vendor submissions and file processing. This manual process took a significant amount of time and resulted in data errors that led to manual remediation, prolonged processing time and an increased risk of submissions requiring correction and resubmission.  

Novo Nordisk needed a solution that incorporated automated data validations throughout the CMS submission process to reduce the time-to-completion of tasks associated with this critical compliance process and engaged Baker Tilly to help.

Strategy and solution

Baker Tilly began by mapping Novo Nordisk’s end-to-end spend transparency data processing to identify opportunity areas for automation. Working under a tight timeline, the team designed and implemented an automated data validation solution that leveraged Novo Nordisk’s pre-existing Snowflake data warehouse. 

Key components included: 

• Automated ingestion and reconciliation of data from multiple sources (including their spend aggregation system and data coming back from CMS) and incorporated data validation to ensure accuracy of remaining manual data ingestion efforts  
• A centralized data repository to support data processing and analytics capabilities 
• Power BI dashboards for data visibility, validation and data insights 

Baker Tilly also provided training and standard operating procedure (SOP) documentation to ensure the smooth adoption of the new process. The automated solution provided Novo Nordisk with the following results: 

• Reduced submission inputs from 8 to 1 (88% reduction) 
• Reduced overall processing time from weeks to days 
• Cut processing time for system rejections by 66% (from ~60 to ~20 minutes) 
• Increased file creation capacity by 75% (from one to four entities processed simultaneously) 

Overall, the streamlined process has significantly reduced manual inputs leading to faster resolution and efficiency during CMS submissions.