According to the agency, these reports would combine Medicare claims data with private-sector claims data to identify which physicians and hospitals provide the highest quality, most cost-effective care to patients. In this initiative, the CMS would provide standardized extracts of Medicare claims data from Parts A, B and D for a fee to qualified entities that have the capacity to process the data accurately and safely. The data could then be used only to evaluate provider and supplier performance and generate public reports detailing those results.
The rule also calls for these organizations to share their reports confidentially with providers and suppliers before they're released in an effort to prevent mistakes. Meanwhile, publicly released reports would include only aggregated information, which means individual patient and beneficiary information would not be shared or available.
“Making more Medicare data available can make it easier for employers and consumers to make smart decisions about their healthcare,” CMS Administrator Dr. Donald Berwick said in a statement about the proposed rule. “Performance reports that include Medicare data will result in higher quality and more cost-effective care.”
"Any applicant who meets the criteria in the final rule is eligible to become a qualified entity, and we do not want to predict which organizations will be granted that designation," Brian Chiglinsky, a CMS spokesman, wrote in an e-mail. "However, there are many regional organizations who have already begun measuring provider performance and reporting that performance to the public. Wisconsin Health Information Organization, Pacific Business Group on Health and Minnesota Community Measurement are some examples of the many organizations who are providing consumers valuable information on provider performance today."
The proposed rule will be published in the Federal Register on June 8, and the CMS will accept public comments for 60 days following that date.