Medicare Data Will Become Publicly Available

On June 3rd, the Centers for Medicare and Medicaid Services (CMS) announced proposed rules that will give certain organizations access to Medicare data.  The proposed rule supports efforts of the health reform law to improve health care quality and lower costs. 

Currently, private insurance companies sometimes make quality assessments on physicians based on their own claims data.  While the goal of the reports was and is to identify hospitals and physicians with the highest quality and cost-effective care, providers can receive multiple and sometimes contradictory reports from a variety of insurers and are often unable to appeal or correct inaccuracies in those reports.

Because Medicare is the largest payer in the US health care system, it's claims data can make quality measures more accurate.  The proposed rule will allow certain organizations access to Medicare claims data and would offer a more accurate snapshot of the performance of physicians and hospitals by ensuring the organizations that crunch the data combine both private sector claims data with Medicare data.  These organization would be required to share the reports confidentially with the providers prior to their public release.  In this way, physicians will have an opportunity to review and work with the company to prevent mistakes in the reports.    Public reports will contain aggregated information only, and no individual patient data will be shared.

CMS will formally publish the rule in the June 8th Federal Register and accept public comment for 60 days.