Andy Slavitt, Acting Administrator, Centers for Medicare & Medicaid Services (CMS)
CMS partners with commercial and state insurers to support primary care practices and reduce clinician burden
- Seamless interaction between point of care solutions and other entities, including through the use of standard APIs. Health IT developers can play a key role in this vision by making it easier for clinicians to share data between their EHRs and other applications or services, such as registries, empowering clinicians to assemble the right tools and services for their practice.
- Growth of third-party entities that can meet provider data access and reporting needs. Clinicians will benefit from a robust marketplace of trusted entities that can perform core functions like facilitating quality reporting to all payers, combining data from disparate sources of care in a medical neighborhood and presenting it in a usable way, and helping clinicians to understand data on their patients—at a reasonable cost. For instance, vendor partners working with select regions participating in the Comprehensive Primary Care initiative have made important progress in recent years by providing aggregate feedback reports including data from both Medicare and commercial payers.
- Use of low-cost shared services necessary for aggregating and linking data. Value-based payment relies on a variety of core services, such as accurate information on the identity of patients and providers to carry out key tasks like attributing patients to providers. Stakeholders could realize significant efficiencies by coming together around shared governance and financing for such services. Many of the participants in the Center for Medicare and Medicaid Innovation (CMMI) State Innovations Model have taken just such an approach.
- Greater data transparency and data consolidation. Efforts like state All Payer Claims Databases and Medicare Qualified Entities that bring together data from multiple payers in one place can provide stakeholders with a single place to go for data, while reducing the burden on the payers who want to make their data available.
- Standardization of key patient data needed for quality measurement. ONC and CMS can assist in fostering ongoing standardization of data for measures as well as development of related tools, such as libraries of data elements that allow new electronic measures to be easily captured, calculated and reported for use by clinicians and consumers.
- Alignment around how quality is measured and reported across payers. By coming together around common quality measures and reporting mechanisms payers can ensure clinicians have access to more useful, aggregated performance feedback, while increasing the comparability and auditability of measurement results. Efforts such as the Health Care Payment Learning and Action Network, and the Core Quality Measurement Collaborative (which identified 7 core sets of quality measures that CMS and commercial payers have committed to using) have begun to make such alignment possible.