CMS Data Chief Urges Use of Medicare Data Analytics, Tools

Mandated under the Affordable Care Act to meaningfully share its massive volume of data with healthcare stakeholders, the Centers for Medicare and Medicaid Services continues to ramp up its data collection, analysis and dissemination.


Mandated under the Affordable Care Act to meaningfully share its massive volume of data with healthcare stakeholders, the Centers for Medicare and Medicaid Services continues to ramp up its data collection, analysis and dissemination.

That’s the message Niall Brennan, director and chief data officer at CMS, brought to the Healthcare Analytics Symposium in Chicago, sponsored by Health Data Management. The task hasn’t been pretty; when Brennan came to CMS data was in 876 sites within the agency.

Over time, CMS has gotten better at understanding healthcare trends and distributing the right information to the right people at the right time and in the right format, Brennan said. As the nation’s largest health insurer and serving 123 million individuals, the agency is focusing on delivering analyses that resonate with the business needs of stakeholders.

Brennan walked through a range of programs to analyze and disseminate data to help healthcare become more transparent. CMS, he asserted, is “all in” on data transparency, making more machine readable and de-identified data available publicly. Some of the early and well-known initiatives include the Hospital Compare and Physician Compare Web sites to help consumers make more informed choices when seeking care.

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But the agency now has a range of different services for researchers and other stakeholders. One dashboard, for instance, shows the per capita cost down to the county level for individuals with 6 or more chronic conditions. And Medicare now offers provider utilization and payment, hospital charge data, and prescribing data on more than one million Medicare providers.

In total, Brennan said, available data now represents about half of Medicare spending. Some examples: A chronic condition warehouse contains 315 billion records. A virtual research data center enables researchers to use their own laptops to remotely access and analyze data. Medicare claims data is available to qualified entities for performance evaluation of providers, with delivery of actionable performance reports that cover most or all of a provider’s practice.

And, Medicare increasingly is sharing data with accountable care organizations, sending monthly near real time data to facilitate care coordination for patients assigned to an ACO. Data feeds include beneficiary claims history including service types, procedures and supplies. Medicare also offers a 30-day all-condition hospital readmission rate analyses with a three-month lag. The analyses show a high and stable readmission rate from 2007 through 2011, then reductions that started in 2012 and continue today.

Other data services available include generic drug dispensing rates per region across the nation, comparing all doctors in a city or region on their prescribing rates, comparing opiate claims by state, county and individual physician levels; and a new look at Hepatitis C drug episodes in Medicare Part D by region.

But some initiatives still need significant improvement, Brennan acknowledged. The Blue Button project to enable consumers to download up to three years of their hospital, physician and pharmacy data remains in an unfriendly ASCII text format, but Blue Button is being modernized.

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