A broad coalition of improvement organizations, all payor claims database organizations, hospital associations, medical societies, and foundations have signed a letter sent to Sen. Max Baucus, Sen. Orrin G. Hatch, Rep. Dave Camp and Rep. Sander Levin regarding Medicare data release.
In our letter, we make two critical asks of Congress:
1. Allow QEs (Qualified Entities) to provide their subscribers access to Medicare data and develop custom proprietary (i.e., non-public) reports that are specific and useful for improvement purposes. This is a key factor in an All Payor Claims Data Base's (APCD) ability to provide useful and actionable information. For example, APCD users can run reports comparing one provider to another on a given quality metric using comprehensive claims information.
2. Permit QEs to charge a fee to subscribers accessing data and reports. QEs are required to pay CMS for access to the data; they also incur significant costs for integrating and maintaining the data systems to support the analysis. A number of Regional Collaboratives and APCDs rely upon member or subscriber fees to operate. Potential subscribers should include as broad a group as possible, including physicians, medical groups, medical societies, hospital and health systems, insurers, other payor organizations, data analytic firms and other participants in the healthcare marketplace.
Without allowing these financing models, QEs will be forced to rely on public funding, which may or may not be available.
Release of Medicare data with these two fundamental changes to the present law governing Medicare data is absolutely fundamental to driving improvement in American healthcare. This can be accomplished by adding these provisions to the bill that will address the Sustainable Growth Rate Fix for physician Medicare payments which will pass sometime this year.
To read the letter, click here - Congressional Letter on Medicare Data-c