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Medicare claims data could improve care, JAMA article by Toussaint, Berwick says

In an article in The Journal of the American Medical Association (JAMA), Wisconsin Medical Society member John Toussaint, MD, and Donald Berwick, MD, former administrator of the Centers for Medicare & Medicaid Services (CMS), called for changes to the Affordable Care Act (ACA) that would allow broader access to and use of Medicare fee-for-service (FFS) claims.

“Access to Medicare fee-for-service data could help increase efficiency in health care delivery, reduce costs and improve the quality of care,” said Dr. Toussaint, CEO of the ThedaCare Center for Healthcare Value, and Dr. Berwick, co-founder of the Institute for Healthcare Improvement. While the ACA permits Medicare claims data to be released to qualified entities (QEs), it also “tightly limits what organizations can do with the data and their ability to support their own data maintenance infrastructures.”

The Wisconsin Health Information Organization (WHIO) meets the criteria as a QE, but it cannot share Medicare FFS data with subscribers for quality improvement and cost-efficiency purposes and cannot charge subscriber fees, which is necessary for entities such as WHIO to recoup costs, the article said.

Late last month, Dr. Toussaint, Society Chief Executive Officer (CEO) Rick Abrams and WHIO CEO Jo Musser met with U.S. Sen. Tammy Baldwin and U.S. Reps. Ron Kind, Tom Petri and Paul Ryan to seek support for an ACA amendment that would allow WHIO and other entities to use Medicare FFS data in the same way other data is used. Details about their visit to Washington, DC, are in the June 27 issue of Medigram.

An abstract of the JAMA article is here.

Back to July 11, 2013 Medigram