CMS Perspectives on Transparency and The Use of Data to Drive Patient Centered Care
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1 CMS Perspectives on Transparency and The Use of Data to Drive Patient Centered Care Niall Brennan Chief Data Officer Centers for Medicare & Medicaid Introduction CMS is the largest single payer for health care services in the US Expected to serve over 125 million individuals in 2016 between the: Medicare program (health insurance for individuals age 65 and older, as well as those with disabilities) Medicaid/CHIP program (health insurance managed by the states for individuals with lower incomes) Over 11 million plan selections during the 2015 open enrollment period for the federal and state health insurance marketplaces 2.5 billion claims submitted annually for the Medicare FFS program alone Significant new data sources Meaningful use of health information technology Provider quality information Health Insurance Marketplace data Trusted to protect beneficiary privacy 2 1
2 CMS Data and Delivery System Reform Information is a key driver of delivery system transformation CMS data can provide critical insights that can inform and drive health system change and make the system more transparent, affordable, and accountable All health system actors can benefit from better data and information and a vibrant health data ecosystem To promote delivery system transformation, CMS is: Employing advanced analytics to create actionable information products, accelerate transparency, inform policy decisions and evaluate programs Routinely and safely sharing data with numerous stakeholders to drive health care quality and efficiency improvements and lower health care costs Driving unprecedented efforts around health data transparency 3 CMS Data Transparency Better access to health system information is a key goal of the Secretary s Delivery System Reform initiative CMS, HHS, and the White House have made a commitment to greater data transparency Since 2010, CMS has released an unprecedented amount of aggregated, de-identified data in machine-readable form Geographic Variation and Chronic Condition PUFs Hospital Inpatient, Hospital Outpatient, and Physician PUFs CMS Data Navigator ( makes it easy to find CMS data and information products on our website 4 2
3 Medicare Provider Utilization and Payment Data Public data sets with payment and utilization information for services and procedures provided to Medicare beneficiaries Data released to date covers 60% of Medicare program payments May 2013 April 2014 April 2015 May 2013 Hospital Physician & Part D Inpatient & Other Supplier Prescriber Outpatient 3,000+ Hospitals 150,000+ records 100,000 page views 880,000+ NPIs 9+ million records 166,000 page views 1+ million NPIs 23+ million records 16,000 page views in first month 5 Search for a provider by name, address, or National Provider Identifier (NPI) Tool returns information about the services the provider furnished to Medicare beneficiaries Available for services/procedures (Part B data) and prescription drugs (Part D data) User Friendly Interfaces 6 3
4 Significant Use of Data by External Stakeholders Access to granular data promotes development of external tools Data used in several hackathons including at Health Datapalooza in Data Sharing for Care Coordination CMS is sending near real-time monthly data to facilitate care coordination to: Accountable Care Organizations (ACOs) for patients assigned to the ACO State Medicaid programs for Medicare-Medicaid enrollees Data is essential for analyzing the full continuum of care for beneficiaries Feeds include beneficiaries entire claims history, including all service types, procedures and supplies. Opportunity for private sector to help transform the data to clinical information 8 4
5 Data Sharing for Performance Measurement Qualified Entity (QE) Program authorizes the release of Medicare claims data to QEs for performance evaluation of providers QE Program changes the performance measurement landscape by facilitating the creation of actionable performance reports that cover all/most of a providers practice PAST PRESENT INSURANCE COMPANIES MEDICARE? INSURANCE COMPANIES MEDICARE? Qualified Entity COMPREHENSIVE CONSISTENT FAIR ACTIONABLE 9 MACRA Changes to Qualified Entity (QE) Program Currently, QEs may only use Medicare data to create public reports that evaluate the performance of providers of services and suppliers The Medicare Access and CHIP Reauthorization Act (MACRA) expands permissible uses of CMS data to allow QEs to: Provide or sell analyses to authorized users for non-public use Authorized users include providers/suppliers, issuers, employers, medical societies/hospital associations, and any other entity approved by the Secretary Provide/sell combined data OR provide Medicare claims data at no cost to providers/suppliers and medical societies/hospital associations for nonpublic use MACRA also includes additional privacy and security requirements for QEs, such as requirements for a data use agreement (DUA) between the QE and the authorized user and fines for a breach 5
6 Federally Inspired BlueButton Community VA DoD (TRICARE) CMS CMS Launched BlueButton in 2010 and it is still in regular use today CMS users Beneficiaries can download up to 3 years of claims data Hospital Physician Prescription drugs Downloads/Month Private sector applications already ingest, optimize and visualize data * Cross Agency Metrics - May BlueButton must adapt to fulfill a critical role in a Patient-Centered Health System based on Value and Quality Beneficiary ACOs Near-Time Specific Historical Generic Precision Medicine Care Coordination 12 6
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