The Centers for Medicare & Medicaid Services (CMS) today announced a new data and information initiative that will be a key tool in the agency’s evolution from a fee-for-service based payer to a value-based purchaser of care.
The data and information initiative will be administered through a new Office of Information Products and Data Analytics (OIPDA) that will oversee CMS’s comprehensive portfolio of data and information. Under OIPDA, the development, management, use, and dissemination of data and information resources will become one of CMS’s core functions. Ensuring the privacy and security of personal health information remains a top priority as OIPDA improves access to, and use of, CMS data and information resources. With timely, relevant data, CMS and its partners will be better able to define and reward high quality, low cost care.
This effort also enhances data analytics and management strategies that are being widely promoted through programs by the White House Office of Science and Technology Policy.
CMS provides healthcare coverage for more than 100 million Americans through Medicare, Medicaid, and the Children's Health Insurance Program (CHIP). Under Medicare alone, CMS processes more than 1.3 billion claims a year, and generates billions of other non-claim data points, such as eligibility checks, 1-800 MEDICARE queries, quality metrics and enrollment information. Additionally, CMS is receiving data submissions under the meaningful use requirements of the Medicare and Medicaid Electronic Health Records Incentive Programs and beginning to collect Medicare Advantage encounter data. Similarly, beginning in 2014, CMS will receive health insurance exchange data related to the coverage expansions under the Affordable Care Act.
This wealth of data is critical to decision making for CMS and other stakeholders in the nation’s health care system. CMS must leverage this data to inform internal decisions and has a public responsibility to provide appropriate access to data (while ensuring beneficiary privacy) to external stakeholders in order to facilitate healthcare innovation. At the same time, CMS recognizes the critical role of analytics in transforming data resources into information and insight. Through the creation of OIPDA, CMS is focusing resources to improve data access and dissemination, and enabling the development of new products and analysis tools designed to harness its data resources to better highlight relevant and actionable information for internal and external policy and decision makers. In all of these activities, CMS will ensure that all data release and dissemination processes follow privacy laws and regulations and that the release of beneficiary identifiable data is limited to cases permitted by statute and regulations. OIPDA will also focus on creating new and innovative mechanisms, such as virtual data centers that allow data users remote and secure access to the data, to improve appropriate access to beneficiary identifiable data for research and analysis, while simultaneously increasing data security.
Functions of the Office of Information Products and Data Analysis
OIPDA will assume responsibility for many current CMS data functions, including:
• Management of the Chronic Condition Warehouse (CCW), which is designed to support multiple analytic functions and includes patient-centric data files linked by a unique beneficiary identifier across the continuum of care from 1999 to present day. The CCW also contains Medicaid data, assessment data, and provider enrollment data.
• Administration and production of the Medicare Current Beneficiary Survey (MCBS), which is the largest continuous survey of Medicare beneficiaries in the country. The MCBS provides stable estimates and information on the Medicare population, such as expenditures and sources of payment for services used by beneficiaries, changes in health status, satisfaction with care, and usual source of care.
• Management of the Medicaid Analytic Extract (MAX), which is designed to summarize Medicaid data from the Medicaid Statistical Information System (MSIS).
• Oversight of the Research Data Assistance Center (ResDAC), which provides training and technical assistance for external users requesting CMS data.
• Oversight of the Medicare Data Sharing for Performance Measurement Program (ACA Section 10332), which provides extracts of all Medicare claims data to qualified entities who then combine the Medicare data with claims data from other payers to create comprehensive, actionable quality assessments for health care providers.
• Publication of aggregated Medicare demographic, spending, utilization, and quality information at the Hospital Referral Region (HRR) level.
• Oversight of the Medicare “Blue Button” initiative that permits beneficiaries to easily download their Medicare claims history.
OIPDA will also coordinate the agency’s data policies and requirements to ensure their efficient and strategic alignment. Other CMS components will continue to collect, store, and analyze data for their specific business needs, with OIPDA being responsible for ensuring that the CMS enterprise maximizes its data resources, transforming the agency into a data driven organization.
New OIPDA Data and Information Products
As first steps under the new data and information initiative, CMS is announcing the release of several new data and information products:
• Medicare Geographic Variation Trend Data: CMS is announcing a unique data set that leverages almost 5 billion Medicare claims over a four-year period into an easy-to-use data resource at the state and HRR levels. The data set includes numerous variables, such as demographics, spending, utilization and quality of care, across four years (2007-2010). This data set permits a variety of users with varying levels of experience with Medicare data to quickly understand and adapt the data to specific projects, and provides the ability to assess and compare their state’s or HRR’s Medicare performance against that of other areas or the national average. The data is on the Institute of Medicine website and will be available in the Health Indicators Warehouse by mid-summer 2012. View: http://www.iom.edu/Activities/HealthServices/GeographicVariation/Data-Resources.aspx and http://healthindicators.gov/Indicators/.
• Medicare Enrollment Dashboard: CMS is announcing an online dashboard that provides comprehensive statistics on Medicare enrollment (Parts A, B, and D and Medicare Advantage), including detailed information on enrollment patterns at both the national and state level for recent years, as well as historical trend data on overall Medicare enrollment beginning in 1966. This replaces a process where interested parties had to obtain information about Medicare Parts A, B, D and Medicare Advantage enrollment from multiple locations on the CMS website. Visit: http://www.cms.gov/Research-Statistics-Data-and-Systems/Statistics-Trends-and-Reports/Dashboard/View-Dashboards-Items/Medicare-Enrollment-Dashboard-BETA.html
• Medicare & Medicaid Research Review (MMRR): CMS recently launched a new peer-reviewed online journal to support dissemination of high-quality and relevant research to a wide audience of Medicare, Medicaid, and Children's Health Insurance Program stakeholders. MMRR is currently accepting manuscripts that report on issues involving health care coverage, quality and access to care for beneficiaries, and payment for health services. MMRR will also publish CMS Data Briefs, summarizing complex statistical topics in easily understandable language designed to inform a more diverse community of health analysts and policymakers. Visit: www.cms.gov/Research-Statistics-Data-and-Systems/Research/MMRR/index.html.
• CMS Data Navigator: This web-based search tool rapidly connects researchers, policy makers, and the general public to the CMS data resources they need. Additionally, Navigator results will also link to CMS data housed on external web sites such as the Kaiser Family Foundation, the Institute of Medicine, and the Health Indicators Warehouse. Navigator search results will include publicly available data files, statistics, reports, fact sheets, and interactive tools. The Navigator will significantly improve the transparency of CMS data, allowing users to easily locate CMS data that is currently located in multiple locations on the CMS website. The Navigator is expected to reduce the number of Freedom of Information Act (FOIA) requests for data already available on CMS.gov. The Data Navigator is scheduled to be in operation by mid-summer 2012 and will be located on the CMS.gov website.
More information on CMS’s initiative is available at http://www.cms.gov/Research-Statistics-Data-and-Systems/Research/ResearchGenInfo/OIPDA.html.