CMS opens up claims data for makers of commercial products

The Centers for Medicare & Medicaid Services is opening up its data stores to innovators to help them create tools for the commercial marketplace, Andy Slavitt, acting administrator for the agency, said Tuesday morning at Health Datapalooza. CMS is starting to use information to improve the care delivery system, but "needs your help," Slavitt said to the audience at the annual event in the District of Columbia.

"While this is a big departure, we do this with a clear expectation that you will create a new stream of tools that will improve care and personalize decision-making," he said. "We're allowing companies to combine CMS data with other data, so even what were small silos of data can have enough credibility" to be of use.

The Medicare claims data will be stripped of patient, but not provider, identifiers. In addition to opening the data, which was previously only available to researchers, Slavitt said the agency will move from an annual to a quarterly update of its data for researchers and innovators. CMS also will require certain data submitted to the agency for use by consumers to arrive in machine-readable format, he said.

As long as innovators and entrepreneurs are willing to go through the process of having their work designated as HIPAA-approved research, they will have virtual access to granular CMS claims data in the CMS Virtual Research Data Center, Niall Brennan, chief data officer for CMS, added during a panel later in the day.

"That is really cool; you're not limited in how you use the results or integrate them into your tool," he said.

Slavitt said as innovators create new business models and determine priorities, areas they should considering focusing on include:

  • Making healthcare the most private and secure data in any industry 
  • Creating products and services that help take care of the country's sickest and most difficult to treat patients
  • Giving doctors and nurses what they want and need the most, including more time with patients

In keeping with its shift to greater transparency of data, the agency also just released information on Medicare reimbursements. The data shows that Medicare reimbursements to doctors are far from evenly distributed, while hospital charges for top procedures and conditions have increased moderately.

To learn more:
- read CMS' announcement