CMS Announces First Qualified Entities to Receive Medicare Data

The Centers for Medicare & Medicaid Services (CMS) has announced the first three participants in the Medicare Data Sharing for Performance Measurement program. Authorized under the Affordable Care Act, the program makes Medicare claims data available, under strict privacy requirements, to groups that CMS certifies as qualified to handle this data and protect patient privacy. These groups will combine Medicare and private insurance data to create comprehensive, useful reports on provider performance.

The three organizations are:

• Health Improvement Collaborative of Greater Cincinnati
• Kansas City Quality Improvement Consortium (serving the Greater Kansas City area in Missouri and Kansas)
• Oregon Health Care Quality Corporation

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.

The program takes important steps to protect the privacy of patients. Information that could identify specific patients will not be publicly released and strong penalties will be in place for misuse of the Medicare data.

With access to provider performance reports, employers and consumer organizations can identify and reward high quality health care providers in their local areas and develop online tools to help consumers and their families make health care choices informed by this useful data.

For more information on CMS’ Qualified Entity Program, visit:
http://www.cms.gov/QEMedicareData/