March 10, 2015
Joel White (CAHC): (202) 744-1806 or firstname.lastname@example.org
Larry McNeely (NCHC): email@example.com
John Toussaint (ThedaCare): firstname.lastname@example.org
Elizabeth Mitchell (NRHI): email@example.com
Broad Support for Bipartisan Legislation to Expand Access to Data to Improve the Quality and Cost of Health Care
Data-sharing bill embodies bipartisanship on health reform
Washington, D.C. (March 11, 2015) – Today, 37 organizations representing patients, providers, insurers, employers and researchers called on Congress to quickly pass bipartisan legislation that amends the Qualified Entity (QE) statute to allow for broader sharing of Medicare data. The Quality Data, Quality Healthcare Act was introduced on March 9th by Senators Tammy Baldwin (D-WI) and John Thune (R-SD). The House version of the proposal was introduced on February 6th by Congressman Paul Ryan (R-WI) and Congressman Ron Kind (D-WI).
Joel C. White, President of the Council for Affordable Health Coverage and head of the Clear Choices Campaign, said, “This bill will put data in the hands of experts who will be able to identify and correct many of the problems plaguing our health system – high cost, poor quality, bad health outcomes. We are encouraging Congress to take the bill up immediately.”
The legislation will provide more flexibility to data crunchers, known as Qualified Entities, by permitting them to use and share actionable data with providers, payers and health care consumers. The bill revises the QE program by broadening non-governmental access to claims data collected under the Medicare program. Current law, enacted in 2010, gives QEs access only to Medicare claims data (Parts A, B and D), and requires that all analyses be published. The reforms would permit QEs to provide analyses and, in some cases, data for a range of non-public uses, such as assisting providers in developing and participating in quality and patient care improvement activities, population health management, disease monitoring and insurance network development and selection.
As a result, the legislation will:
- Double the amount of data available for analysis;
- Expand the number of experts who can analyze the data; and
- Permit more uses of the data, such as for developing new models of care, improving benefit design, or identifying wasteful or unsafe practices.
John Rother, President and CEO of the National Coalition on Health Care said, “By enabling consumer transparency tools to draw on Medicare’s vast trove of cost and quality data, these reforms will bring us closer to the day when every consumer can access clear understandable cost and quality information on their provider and treatment choices.”
The bill has been included in numerous proposals, including:
- SGR Repeal and Medicare Provider Payment Modernization Act of 2014
- House Ways and Means Health Subcommittee Chairman Kevin Brady’s Hospital Improvements for Payment (HIP) Act of 2014 Discussion Draft
- House Energy and Commerce Committee Chairman Fred Upton’s 21st Century Cures Discussion Document White Paper
In addition, the President’s FY 2016 Budget included a proposal to expand data sharing through the QE program.
“Healthcare costs are rising faster than quality is improving,” says Dr. John Toussaint, CEO of ThedaCare Center for Healthcare Value. “Healthcare cost and quality data, including Medicare data, are largely unavailable to purchasers and consumers, so the market can’t reward the ‘good guys.’ Medicare’s qualified entity program was a well-intended program to make Medicare data available for assessment of cost and quality, but there are limits in the statute as to how the data can be used.”
Elizabeth Mitchell, CEO of the Network for Regional Healthcare Improvement, added, “We believe that Medicare data contains critical information that if made more fully available would help empower communities across the country to identify opportunities to improve value in healthcare.”
White concluded, “The QE language is a product of many compromises carefully crafted over years of intense, bipartisan negotiations,” he said. “There aren’t many things Republicans and Democrats agree on these days, but providing additional data to promote a better, lower cost health system is clearly one of them. With such overwhelming support for better tools to shop for better, more efficient care, health care transparency is a win for consumers, payers and politicians.”
Endorsing the QE language is a diverse group of stakeholders, from AARP to the National Association of Manufacturers, including both supporters and critics of the Affordable Care Act. The letter can be found here.
About Council for Affordable Health Coverage
CAHC is a broad-based alliance with a singular focus: bringing down the cost of health care for all Americans. Clear Choices is a campaign of the Council for Affordable Health Coverage representing patients, health care providers, insurers, employers and life science companies to improve health care transparency. Clear Choices advances solutions to empower consumers to make better health choices, leading to a more robust, more competitive and less costly health care system.
About National Coalition on Health Care
NCHC, the oldest and most diverse group working to achieve comprehensive health system reform, is a 501(c)(3) organization representing more than 80 participating organizations, including medical societies, businesses, unions, health care providers, faith-based associations, pension and health funds, insurers and groups representing consumers, patients, women, minorities and persons with disabilities. Member organizations collectively represent – as employees, members, or congregants – over 100 million Americans.
About Network for Regional Healthcare Initiatives
The Network for Regional Healthcare Improvement (NRHI) is a national organization representing over 30 member Regional Health Improvement Collaboratives (RHICs). These multi-stakeholder organizations are working in their regions and collaborating across regions to transform the healthcare delivery system and achieve the Triple Aim: improving the patient experience of care, including quality and satisfaction improving the health of populations; and reducing the per-capita cost of health care. NRHI’s overarching vision is to bring stakeholders together to improve health and healthcare in communities across the US through an active and engaged network.
About ThedaCare Center for Healthcare Value
The ThedaCare Center for Healthcare Value is an education institute that believes we must have three essential elements for sustainable change in healthcare: delivery of care designed around the patient, payment and incentives based upon value and outcomes, and transparency of performance (quality and cost) throughout the healthcare system. Founded in 2008 and headquartered in Appleton, WI, the Center is a small not for profit with a big mission to help change the healthcare industry.