The Centers for Medicare and Medicaid Services has certified the Health Care Cost Institute as the first national "Qualified Entity" to have full access to national Medicare claims data for reporting on the costs and quality of healthcare services.
Under the Affordable Care Act, the Qualified Entity Program permits select organizations to combine Medicare Parts A, B, and D claims data from CMS with other payer data to evaluate the performance of providers, services, and suppliers. As a Qualified Entity, HCCI will have access to 100 percent of the nation's traditional Medicare claims data and about 40 percent of Medicare Part D prescription drug claims data. Currently, HCCI also holds data on roughly 40 percent of the Medicare Part C managed care population.
The addition of comprehensive Medicare claims data will now afford HCCI a unique and unprecedented opportunity to track and publicly report on healthcare trends using both public and commercial data, said the institute in a written statement. Moreover, HCCI intends to convert its access to the Medicare data to a research license to pursue a broad research agenda using the combined dataset containing information on more than 100 million individuals.
According to HCCI, it currently holds one of the largest private health insurance claims databases available for public reporting and academic research purposes. Launched in 2011 with support from Aetna, Humana, Kaiser Permanente and UnitedHealthcare, HCCIs mission is to promote independent, nonpartisan research and analysis on the causes of the rise in U.S. health spending.
"The national Medicare cost data set will be a powerful addition to the HCCI transparency initiative, providing essential information to help us better understand what is needed to improve the quality and performance of the U.S. health system," said David Newman, executive director of HCCI. "Public reporting, as permitted with these data, when combined with cost and quality data from commercial health plans and state Medicaid data will represent the most credible information source for consumers, regulators and employers on health care cost and quality variation."
In May, HCCI announced that it will create and administer an information portal that will provide consumers, employers and regulators free access to consistent, comprehensive information about the price and quality of healthcare. Aetna, Humana, and UnitedHealthcare have agreed to provide information on healthcare costs to HCCI. Other participating commercial insurers will be announced soon. The new online tool is expected to be available in early 2015.
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