JUL 28, 2011 12:26pm ET

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CMS Database to Aid Consumers, Track Payer Compliance with Reform Law

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The Centers for Medicare and Medicaid Services intends to build a Health Insurance Assistance Database to better serve consumers inquiring about provisions of the Affordable Care Act.

The CMS Center for Consumer Information and Insurance Oversight receives hundreds of consumer inquiries each month. "Accordingly, a system to collect, track and store consumer information is urgently needed in order to accomplish successful case management to ensure that the information, coverage and health care needs of consumers are addressed fairly and in a timely fashion," according to a notice available now and being published July 29 in the Federal Register.

Analysis of inquiries and reports of payer activities by consumers also will help identify practice patterns in the insurance marketplace and uncover suspected patterns of noncompliance with Affordable Care Act provisions, according to the notice. Data also can give the Center for Consumer Information and Insurance Oversight indications of the effectiveness of state enforcement. Reports generated from the database will be stripped of identifiable information and personal health information.

 

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Looking to build better care coordination, health systems are buying physician groups in droves. Making the deal work, however, requires careful management on the I.T. front.

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