CMS Plans to Sell Medicare Claims Data to Improve Healthcare

Organizations that are designated as qualified entities may obtain Medicare data to combine with other claims data.

The US Centers for Medicare and Medicaid Services (CMS) recently announced that it will now expand access to patient data to healthcare providers, employers, and others.

The Qualified Entity Program allows organizations that meet specific criteria to obtain patient-protected Medicare data to create public reports, according to a press release from the CMS.

Providers, employers, and other groups deemed qualified will be able to obtain analyses of Medicare claims data in hopes of improving patient care. These analyses will either be shared or sold.

The data must be accompanied by other claims data, such as private payer data, in order to show the efficiency of multiple providers and suppliers, the CMS wrote.

Privacy and security provisions have been made for entities that receive identifiable and de-identified analyses or data. The groups receiving the data must, at the very least, comply with HIPAA Privacy and Security Rules.

The reasoning behind the new rule is to allow the healthcare system to provide better care and reduce costs, resulting in a healthier overall population, according to the CMS. Thus far, 15 organizations have been approved to be a qualified entity.

“Increasing access to analyses and data that include Medicare data will make it easier for stakeholders throughout the healthcare system to make smarter and more informed healthcare decisions,” CMS Chief Data Officer Niall Brennan said in the release.