The Medicare data release rule called the "Availability of Medicare Data for Performance Measures" or rule CMS 5059-P has been in a comment period for a few weeks. The Wisconsin Health Information Organization commented on the rule this week and these comments are included at the bottom of this blog.
There are a number of issues with the rule as presently structured but we consider three big ones in this simple summary,please read the entire comment for further important details.
1. Cost. Medicare proposes to charge 80-100,000 dollars per year for entities such as WHIO to access the data. Much of this cost is justified by the cumbersome audit process CMS has proposed for the Qualified Entities that accept the data. WHIO describes how this audit process could be redesigned in a way to reduce the cost. Most all payor claims data base organizations such as WHIO have extremely limited funding and the proposed cost to access the data would limit the number of organizations that can access it. The other way to off set the cost is to allow Qualified Entities to charge for access to the data. It's unclear if CMS will allow this but WHIO is suggesting that should be an option as well.
2. Timeliness. As proposed in 2012 Qualified Entities would be able to have access to Medicare data from 2008, 2009, and 2010. This data is too old and doesn't match with the commercial and medicaid data WHIO receives every 6 months. Every 6 month updates from the previous 6 months of experience is what WHIO believes is required.
3. Integration. Integration of the commercial,medicaid, and medicare data is critical to being able to access provider specific data. As it stands this will not be possible in the proposed rule.
It's good news this data will be released. The Center supports WHIO's proposed changes to the CMS rule which will allow the data to be much more useful to providers who are trying to improve their cost and quality performance.
To read the comments sent to CMS, click here - 20110719 Medicare Data Share WHIO Comments (1)
Leave a Reply