Health care policy experts believe that measuring and publicly reporting information about the performance of physicians and hospitals will be critical in improving the quality of care Americans receive while reining in costs. Community-based organizations around the country, such as those in the Robert Wood Johnson Foundation’s Aligning Forces for Quality initiative, are demonstrating the concept using private medical claims data. They would like to use Medicare claims data, too — a vast pool of information about how health care is being delivered in America, which, if combined with private data, could facilitate more accurate measurement of providers’ performance and better public reports to empower consumers and spur improvements in quality.
A separate but related question pertains to existing data release authority. Under current rulemaking authority, what kinds of things could the administration do to allow greater release of Medicare data to use for measurement, reporting and improvement? This brief concludes that under current law, CMS has the ability to adopt policies allowing for the release of Medicare claims data for research projects and demonstrations with community organizations that meet standards specified by CMS, including capacity to ensure data security and to safeguard patients’ privacy.
