CMS “Medicare Data Sharing for Performance Measurement” program made possible by the healthcare law makes Medicare claims data available under strict privacy requirements to groups that HHS certifies as qualified to handle the data and protect privacy. The combination of Medicare and private insurance data will provide comprehensive useful reports on provider performance.
To receive certain Medicare claims data, organizations participating in the program must show that they can manage and process consumer-focused data and can prevent breaches of protected health information. The organizations must also show that they are working with private insurers to access other payer data in order to produce comprehensive reports on provider performance.
HHS selected three groups under the program:
· Health Improvement Collaborative of Greater Cincinnati
· Kansas City Quality Improvement Consortium
· Oregon Health Care Quality Corporation
“These organizations will make quality and cost information more available and easier to understand for the healthcare systems in their areas,” said Acting CMS Administrator Marilyn Tavenner. “Allowing these organizations to combine Medicare data with other insurers data in public reports, will enable consumers and businesses to have better information on provider performance plus providers will have a greater incentive to improve the quality of care”.
With access to provider performance reports, employers and consumer organizations can identify and reward high quality healthcare providers in their local areas and develop online tools to help consumers and their families make healthcare choices informed by useful data.