CMS has certified the nonprofit Health Care Cost Institute as the first national "qualified entity" to gain full access to national Medicare claims data.
The Qualified Entity Program — created by the Patient Protection and Affordable Care Act — allows select organizations to combine Medicare claims data with other payer data to assess the performance of healthcare providers, services and suppliers, according to a news release. HCCI will now be able to access 100 percent of traditional Medicare claims data and roughly 40 percent of Medicare Part D data. HCCI currently has data on approximately 40 percent of the Medicare Part C or Medicare Advantage population.
This data will allow HCCI to build on its private insurance claims database. The release states, "The addition of comprehensive Medicare claims data will now afford HCCI a unique and unprecedented opportunity to track and publicly report on health care trends using both public and commercial data. 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."
HCCI's qualified entity certification follows the organization's announcement earlier this year that it is working with Aetna, Humana and UnitedHealthcare to develop an online healthcare price transparency tool. HCCI aims to give consumers, payers, providers and others access to aggregate health plan pricing data. The tool's release is scheduled for the first quarter of 2015.
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