Senate Bill Would Increase Access to Medicare Claims Data
U.S. Senators Tammy Baldwin (D-Wis.) and John Thune (R-S.D.) have introduced a bipartisan bill aimed at increasing the transparency of healthcare costs by providing greater access to Medicare claims data.
U.S. Senators Tammy Baldwin (D-Wis.) and John Thune (R-S.D.) have introduced a bipartisan bill aimed at increasing the transparency of healthcare costs by providing greater access to Medicare claims data.
The Quality Data, Quality Healthcare Act would modernize and reform the Qualified Entity (QE) program created by Congress that allows organizations to access and analyze comprehensive Medicare data for select purposes. However, according to the senators, current law is far too restrictive on which organizations can participate in the QE program, what QEs can do with the Medicare data once they have received it and the degree to which QEs can support their own data maintenance infrastructures.
Currently, reuse of Medicare data in the QE program is prohibited for any purpose other than creating publicly available performance reports. In addition, organizations receiving data in the QE program are not permitted to charge subscribers for access to the data.
The proposed legislation would allow organizations receiving Medicare data to analyze and redistribute it to authorized subscribers (insurers, health systems, and physicians) so they can make more informed decisions; as well as permit those entities to charge a fee to their subscribers to support robust analyses to improve healthcare quality and reduce costs. Ultimately, the goal is to increase efficiency in healthcare delivery, reduce costs and improve the quality of care.
Medicare is the single largest payer of healthcare services in the country, spending over $600 billion each year. But we know very little about what we are paying for, said Baldwin in a written statement. The Quality Data, Quality Healthcare Act provides access to that data and puts it into the hands of those who can best use it, helping doctors make more informed decisions and improving how we deliver healthcare.
A summary of the Quality Data, Quality Healthcare Act can be found here.
The Quality Data, Quality Healthcare Act would modernize and reform the Qualified Entity (QE) program created by Congress that allows organizations to access and analyze comprehensive Medicare data for select purposes. However, according to the senators, current law is far too restrictive on which organizations can participate in the QE program, what QEs can do with the Medicare data once they have received it and the degree to which QEs can support their own data maintenance infrastructures.
Currently, reuse of Medicare data in the QE program is prohibited for any purpose other than creating publicly available performance reports. In addition, organizations receiving data in the QE program are not permitted to charge subscribers for access to the data.
The proposed legislation would allow organizations receiving Medicare data to analyze and redistribute it to authorized subscribers (insurers, health systems, and physicians) so they can make more informed decisions; as well as permit those entities to charge a fee to their subscribers to support robust analyses to improve healthcare quality and reduce costs. Ultimately, the goal is to increase efficiency in healthcare delivery, reduce costs and improve the quality of care.
Medicare is the single largest payer of healthcare services in the country, spending over $600 billion each year. But we know very little about what we are paying for, said Baldwin in a written statement. The Quality Data, Quality Healthcare Act provides access to that data and puts it into the hands of those who can best use it, helping doctors make more informed decisions and improving how we deliver healthcare.
A summary of the Quality Data, Quality Healthcare Act can be found here.
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