NBCH Submits Comments to CMS on Availability of Medicare Data for Performance Measurement Proposed Rule

The Patient Protection and Affordable Care Act (ACA) requires Medicare data be made available to “Qualified Entities” for performance reporting. In response the CMS’ proposed rule, NBCH’s Government Affairs Committee developed the attached comments which were formally submitted on Monday, August 8, 2011. Furthermore, the Consumer-Purchaser Disclosure Project also developed comments which NBCH endorsed.

NBCH applauds the Administration’s recognition of the need to broaden the accessibility of Medicare health care claims data so that the quality of care for Medicare recipients and for the nation can continue to improve. Without transparency, we are blind with regard to quality and cost which ultimately are inseparable.

NBCH member coalitions currently participate in, manage, or support efforts to assemble data on the quality of the care provided by individual hospitals and physician practices in their regions. They then disseminate the results to help providers improve the overall quality and value of care, and to help consumers select the highest-quality providers. Unfortunately, these reports cannot provide a complete picture of the quality of health care, particularly for senior citizens, because current restrictions in federal law prohibit the use of Medicare claims data by regional reporting initiatives. NBCH firmly believes that strengthening access to and standardization of all-payer claims data is essential to national public reporting as well as the burgeoning payment reform initiatives. NBCH and our coalition members appreciate the efforts made by the Administration to provide leadership in setting standards and requiring uniformity at a national level. However, as currently written, the regulations impose numerous administrative and cost barriers to coalitions, independent consumer groups, and research organizations to access the raw data needed to measure and improve health care.

Below are our major concerns with the proposed regulations, and attached are detailed comments that NBCH respectfully shared with CMS which may be helpful as modifications to the proposed regulations are considered.

• Cost to Obtain the Data Is Unaffordable for Small Organizations; Level the Playing Field for All Qualified Entities
• Make Data Accessible to Achieve the Greatest Public Benefit; Remove Barriers for Potential Qualified Entities
• Maximize Data Eligibility Requirements for Users
• Balance Measurement Standardization and Flexibility