As the ACA Rolls Out, CMS Begins Sharing Claims Data

For the first time in its history, the Centers for Medicare and Medicaid Services (CMS) will share its Medicare beneficiary claims data for purposes other than research. According to a recent article from The Commonwealth Fund, CMS will share data to outside groups through the Medicare Data Sharing for Performance Measurement Program, which was created by the Affordable Care Act (ACA). So far, seven “qualified entities” have received provisional approval to participate in the program. These qualified entities combine the Medicare claims data with data from other sources (i.e. private health plans and Medicaid) to put together a well-rounded evaluation of the performance of Medicare providers and suppliers. The entities are then obligated to make their evaluation findings publicly available.

According to the Commonwealth Fund article, the new program will allow for more robust data reporting. The data will also help advance the conversation of quality in the Medicare program, as qualified entities are required to respond to physicians’ concerns about their evaluations. CMS is optimistic that more entities will be added to the program over time, with the goal of identifying at least one qualified entity in each state.

Read the Commonwealth Fund article.