MACRA providing expanded opportunity to drive higher quality, lower cost care
Discovering that Medicare and private sector claims data have a great role in providing anĀ improved care, the Centers for Medicare & Medicaid Services (CMS) proposed rules that aim toĀ drive quality and patient care improvement. According to their new rules, the providers,Ā employers, and others can have a greater access to analyses and data rules that will help makeĀ more informed decisions about care delivery. The Medicare Access and CHIP Re-authorizationĀ Act (MACRA) will allow organizations approved as qualified entities to confidentially share orĀ sell analyses of Medicare and private sector claims data. In addition, qualified entities will beĀ allowed to provide or sell claims data to providers. This also ensures to qualify strict privacy andĀ security requirements for all entities receiving Medicare analyses or data, as well as new annualĀ reporting requirements.
āIncreasing access to analyses and data that include Medicare data will make it easier forĀ stakeholders throughout the healthcare system to make smarter and more informed healthcareĀ decisions,ā said CMS Acting Administrator Andy Slavitt. The Obama administration considersĀ this initiative a broader effort to create a health care system that delivers better care, spendsĀ dollars more wisely, and results in healthier people.
The program was authorized by Section 10332 of the Affordable Care Act, allowingĀ organizations that meet certain qualifications to access patient-protected Medicare data toĀ produce public reports. Qualified entities must combine the Medicare data with other claims dataĀ (e.g., private payer data) to produce quality reports that are representative of how providers andĀ suppliers operate. Currently, 13 organizations have applied and received approval to be aĀ qualified entity. Out of these, only 2 have completed public reporting while others are stillĀ preparing for public reporting.