As part of the Affordable Care Act (ACA), CMS proposed new rules last week that would allow authorized organizations to access Medicare claims data that would help them compare physician performance beginning in 2012. The organizations could then combine that data with that from private insurers to ensure a more exhaustive comparison of provider performance. Comparative data would then be released to the public so that employers and consumers could access the reviews and make more informed decisions about healthcare.
According to the proposal, any organization requesting data would “generally be required to use standard measures for evaluating the performance of providers of services.” National Quality Forum indicators, which CMS uses on its Hospital Compare website, would likely be included in the measures. Hospital Compare rates hospitals according to criteria like 30-day mortality rates, patient outcome, readmission rates, and use of antibiotics in inpatient surgeries. The organizations would not have access to specific patient information; therefore it would not be included in their reports.
Currently, organizations must rely on data from private insurers to measure quality of care. The proposed rule would expand the ability to accurately depict quality of care. Hospitals, physicians, or providers singled out in a report would have an opportunity to respond to any care report before its release.
The goal of the proposed rule is to improve the quality of healthcare in theUnited Statesand make healthcare more affordable. As a healthcare provider, it is important that you keep your data accurate and organized to give the best possible representation of your quality of care.
Integrated Data Management Systems can help ensure that your data is organized to give you the most accurate, positive reviews possible.
The experts at IDMS have over 50 years’ combined experience in hospital administration and data abstraction. IDMS works with public and private healthcare organizations to maximize CMS reimbursement by providing accurate documentation and analysis. Once the data is compiled, IDMS will develop an implementation strategy to improve compliance. Contact IDMS today at (972) 922-9800, or email us at integrateddatamgmt@gmail.com to schedule a consultation.
