Groups seek greater CMS transparency, better data standards

In response to lawmakers' call for comments on healthcare data transparency, three industry organizations want the Centers for Medicare & Medicaid Services (CMS) to release more data--and in a more useable form.

"[H]ealthcare-related data is a growing but largely untapped resource for accelerating improvement in healthcare quality and value. The ability to make that data available and useful in a meaningful way will impact healthcare delivery and consumers for years to come," Rick Pollack, executive vice president of the American Hospital Association, writes in a letter to Sens. Ron Wyden (D-Ore.) and Chuck Grassley (R-Iowa).

The AHA calls on CMS to fully release Part B Carrier and the Part B durable medical equipment limited data, Part D prescription drug data and Medicare Advantage Provider Analysis and Review data.

It seeks more timely release of key data sets--quarterly--and a streamlined request process for research identifiable files.

The current state of fragmented data just doesn't work in a value-based healthcare system, Donald W. Fisher, president and CEO of the American Medical Group Association (AMGA), writes in another letter to the lawmakers.

In addition to more CMS data, AMGA calls for development of a central data warehouse to hold administrative claims data from a variety of sources, including federal healthcare programs, commercial payers, labs and pharmacy benefit managers. It suggests Congress require commercial payers to make their data available through that warehouse.

The Electronic Health Record Association (EHRA), meanwhile, foresees problems with that approach. In its letter to the senators, the EHRA advocates making relevant data available through health information exchange (HIE) organizations and software tools such as application programming interfaces (APIs). "The creation of centralized data stores to be queried and/or enabled via APIs outside the context of an HIE-type organization, an approach that is often over-simplified and recommended by researchers, would not be acceptable to the range of affected stakeholders, including patients and consumers," the letter states.

All three organizations call for standard data formats and quality measures as well as patient privacy and data security protections.

Former Health and Human Services Department Secretary Kathleen Sebelius recently said the agency has released more than 1,000 data sets. However, the public launch of a database that will disclose potential conflicts of interest among doctors has been delayed.

And though price transparency efforts are growing across the country, the AHA reports these public and private resources provide varying levels of detail on price and quality of care.

To learn more:
- here's the EHRA letter (.pdf)
- here's the AMGA letter (.pdf)
- read the AHA letter (.pdf)