UX for healthcare payment platform

In December 2025, the Centers for Medicare and Medicaid Services (CMS) began preparing for a law that limits how much Medicare beneficiaries can be charged for certain drugs. To prevent pharmacies from operating at a loss, the law required manufacturers to issue refunds whenever those covered drugs are dispensed to a Medicare beneficiary. Understanding that this created a significant logistical challenge, CMS decided to build a new system for tracking and coordinating refunds to every pharmacy in the country. They called it the Medicare Transaction Facilitator (MTF), and we had 13 months to build it.

Problem

The interfaces built before design resources were available created a major pain point for users associated with multiple organizations: there was no way for a user to tell which organization was currently selected.

Multi-organization users formed a large part of the MTF user base. For example, in a chain with multiple locations, like Walgreens or CVS, each location was considered a different organization. If users couldn't tell which organization was selected, the MTF didn't work for gleaning information about those organizations.

Also, the process for switching between organizations was hidden and inefficient.

Original interface leaves users asking "which organization's claims are these?"

Opportunity

Increase usability and reduce risk of mistakes by ensuring users have a clear sense of which organization is selected and an easy way to switch between them.

Design process highlights

Content strategy

Web apps where users frequently switch between workspaces typically use a text-based dropdown or selectable avatars for this interaction. Avatars wouldn't provide enough real estate for MTF identifiers like pharmacy names and ID numbers, so I opted for a dropdown-based approach.

Deciding between common interaction patterns: selectable avatars vs. text-based dropdowns

The tougher decision: what information should be displayed in the dropdown? Organizations within the MTF don't have a single unique identifier. Most organizations use a National Provider Identifier (NPI) and others use National Council for Prescription Drug Programs (NCPDP) IDs, but both are a series of numbers, so they are hard to tell apart.

Using dropdown items with two rows of information provided enough space to be explicit about which identifier was listed for each organization.

Row 1: Organization name Row 2: ID type and value

Interaction design

Some MTF users are associated with hundreds of organizations, so I knew it would be painful if users had to scroll to select from the available options.

Using a combobox gave users a search-like experience, supported filtering on multiple fields (e.g. name or identifier), and maintained the familiar dropdown pattern for switching.

Comboboxes filter options in the dropdown based on user input

Usability testing

I built a Figma prototype with a multi-state org switcher component and a series of overlays simulating the dropdown interaction for our UX researcher to conduct usability testing.

Across sessions, users consistently identified their current organization, located the switcher, and understood the options presented without confusion. Follow-up testing also confirmed something we'd suspected going in: users actively wanted and expected a fast way to switch, not just a way to see where they were.

Solution and impact

After validating the design for the organization switcher, I brought the designs back to stakeholders from engineering and CMS. I laid out the significance of the problem and the strategy behind the solution by emphasizing the feedback collected from users during testing. The pitch resonated with stakeholders, and the feature was approved for implementation.

During the implementation phase, the dropdown list items were condensed to a single line and the identifier type label was removed to reduce the effort required. Still, the core of the solution was maintained: ensuring users can always identify the context for the rest of the information on the screen, and presenting them with a familiar control for efficiently switching between organizations.

The feature was rolled out as part of the initial product launch in January 2027 and has continued to serve its purpose since then.

Before vs. after redesign