CMS Release of Medicare Data Sets Includes Standardized Payment Amount

For the first time, the Centers for Medicare & Medicaid Services (CMS) has released the Medicare standardized payment amount, which makes Medicare payments across all geographic areas comparable.

The information was part of the third annual release May 5 of the Physician and Other Supplier Utilization and Payment public use data. The data set contains information for more than 986,000 health care providers who received more than $91 billion total in Medicare payments in 2014.

The Obama administration has directed CMS to prepare these public data sets in an effort to make the health care system more transparent to patients, doctors, and consumers. This data provides information on the purpose, payment, and submitted charges behind each service and procedure provided to Medicare patients.

Also new for this year, CMS updated its data access policy, allowing researchers access to Medicare data up to four times a year.  Prior to this announcement, researchers were able to request Medicare data via Limited Data Sets (LDS) only once a year. This change could provide researchers with more meaningful data sets to analyze and help them develop theories for improving health care efficiency and reducing costs.

The data set release came days before the seventh annual Health Datapalooza conference, which brings business and government professionals together to discuss using data, analytics, and technology to redefine health care delivery and payment. CMS Chief Data Officer Niall Brennan said, “This week’s announcements underscore CMS’ ongoing commitment to releasing data and information to promote a vibrant health information economy.”

Speakers at Health Datapalooza touched on the efforts by CMS to provide more visibility into Medicare procedures. U.S. Department of Health and Human Services Secretary Sylvia Burwell said, “When this event began seven years ago, we had a mere 10 data sets around Medicare cost and quality that were openly available to the public. Today, there are more than 2,100 data sets available on HealthData.gov.”

Additional HHS speakers touted the historic progress CMS has made in opening Medicare data to the public, and the impact this wide pool of resources has on health care research. The hope is this increased visibility will lead to advances in cybersecurity, social services, and improved patient care.

Karen DeSalvo, Acting Assistant Secretary for Healthcare and the National Coordinator for Health Information Technology at HHS, summed it up in her speech: “The data is crying out to be used–and consumers are demanding it.”

As Medicare moves from a volume-based to value-based payment structure, releasing these data sets becomes increasingly critical. CMS’ goal to shift 30 percent of payments by the end of 2016 requires openness and visibility into overall use, allowing doctors and health systems to make the necessary shifts in care practices and procedures.

No Comments

    Leave a Reply