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Abrams, Toussaint, Musser visit DC to seek access to Medicare FFS data

Wisconsin Medical Society CEO Rick Abrams and other health care leaders from Wisconsin and Colorado traveled to Washington, D.C., last week to seek an amendment to the Affordable Care Act that would allow the Wisconsin Health Information Organization (WHIO) and entities like the Society to use Medicare Fee-for-Service (FFS) data in the same way other WHIO data is used.

Abrams, WHIO CEO Jo Musser and John Toussaint, MD, CEO of ThedaCare’s Center for Healthcare Value, met with U.S. Sen. Tammy Baldwin and U.S. Reps. Ron Kind, Tom Petri and Paul Ryan. They also joined leaders from Colorado’s Center for Improving Value in Health Care (CIVHC) for meetings with staff from the House Ways and Means Committee and Tim Gronninger, senior adviser for health care policy on the White House’s Domestic Policy Council.

“We are seeking the flexibility for us and other WHIO subscribers to use the Medicare FFS data in the same way we use claims data from other payers to reach our goal of helping physicians provide the highest-quality and lowest-cost care,” said Abrams.

WHIO currently can access the Medicare FFS data as a qualified entity but it cannot share it with subscribers for quality improvement, cost-efficiency purposes and cannot charge subscriber fees. The inability to generate a private funding stream creates instability in WHIO’s financial model, Abrams said.

The Society is a founding member of WHIO, a not-for-profit collaboration of health care providers, insurance companies, employers and public entities created in 2005 to develop a statewide database of health insurance claims. Click here to learn how the Society is using the WHIO data to enhance health care value.

The WHIO database currently includes data from almost all major health care payers in Wisconsin except Medicare FFS. This represents about 65 percent of all health insurance claims in Wisconsin from almost 4 million Wisconsinites and $250 million in claims from a 24-month period. Without the Medicare FFS data, certain specialty areas (such as cardiology) do not have enough episodes of care to make the information meaningful, Abrams said.

“The meetings were very, very worthwhile,” he said. “The people we met with understand the issue, and they understand that WHIO and CIVHC need the Medicare FFS data to enhance quality care and cost efficiency. Once again, Wisconsin physicians are proactively leading the way.”

Back to June 27, 2013 Medigram