Controlled Access CMS Data

Center for Medicare and Medicaid Services (CMS) is strongly committed to the principles of transparency that underpin HealthData.gov and applauds the HealthData.gov redesign. We wanted to take a little time in this blog posting to let you know of several exciting developments regarding data and transparency at CMS that we are very excited about.

First, CMS recently announced the launch of the Office of Information Products and Data Analytics (OIPDA), which will coordinate and lead initiatives to make the development, management, use, and dissemination of data and information resources a core function of CMS.  As Director of OIPDA, I am excited to lead the effort to make more data on CMS programs available in multiple formats, in order to aid data users across the health care spectrum in their efforts to improve health care quality and lower costs. OIPDA is a signal of CMS commitment to enhancing data analytics and management strategies that are being widely promoted through programs by the White House Office of Science and Technology Policy.

While healthdate.gov aims to make as much data available as possible, we have to be careful to stay within the legal guidelines governing release of data, particularly patient-level data. While there are a host of CMS datasets available for immediate download at HealthData.gov, folks interested in certain datasets with protected information will need to come to CMS. I’d like to draw attention to three innovative new data sharing programs being operated by CMS, the “Blue Button” program, data sharing with ACOs, and data sharing for performance measurement.

Blue Button Data

Beneficiary access to their personal Medicare is important for patient engagement in their healthcare.  CMS is dedicated to providing this information in a more timely and user-friendly format through the improvement of the Medicare Blue Button, which allows beneficiaries the opportunity to download their Medicare claims data.  The agency recently expanded the data available from one year to three years and now includes information on Parts A, B, and D and plans to continue to expand the data available and improve the user experience.  Greater beneficiary access to their personal claim history will improve the quality of care provided to these beneficiaries.  The Medicare Blue Button is available at: www.myMedicare.gov.

ACO Data Sharing

Similarly, healthcare professions must also have comprehensive information on their beneficiaries to ensure the provision of high quality patient centered care.  In a fee-for-service system, physicians are often not aware of all the care a patient receives, so are less able to coordinate care or reduce duplicative treatment.  In order to support the mission of Accountable Care Organizations (ACOs), CMS will provide them with monthly feeds of patient level data for the beneficiaries in the ACO.  This comprehensive and timely information will provide the ACO with the information it needs to oversee and coordinate all aspects of its beneficiaries’ care.

Data Sharing for Performance Measurement

Medicare data often represents a significant percentage of a physician’s practice, but is not represented in the numerous quality reports provided for physicians.  Physicians receive performance measurements for a multitude of payers, but seldom receive a comprehensive report for a larger segment of their practice, including Medicare.  The Medicare Data Sharing for Performance Measurement Program (ACA Section 10332) aims to change this by providing extracts of all Medicare claims data to qualified entities for performance measurement.  In order to receive Medicare data, the quality entities must combine the Medicare data with claims data from other payers to create comprehensive, actionable quality assessments for health care providers.  Information on becoming a qualified entity is available at: www.qemedicaredata.org.

CMS has a wealth of data which is critical to the improvement of nation’s health care system. I believe that CMS’s dedication to its data resources will allow the agency and its stakeholders to better highlight relevant and actionable information for internal and external policy and decision makers. Please send any questions on CMS data and information to CMS.data@cms.hhs.gov.