CMS Data & Information Initiative

Niall Brennan, DirectorOffice of Information Products & Data Analytics

CMS

CMS’s Wealth of Data

● CMS is the largest single payer for health care services in the US

● 1.3 billion Medicare claims processed annually

● Significant additional data sources on the way EHRs

Medicare Advantage plan encounter data

Health Insurance Exchange/Medicaid expansion data

● Receive billions of other “non-claim” data points

● Transition from a passive payer to active purchaser

● Expected to drive new innovation in health care

● Trusted to protect beneficiary privacy

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Goal: Data as a Core Function of CMS

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Without timely and relevant data and information, CMS cannot:

Define or reward value

Measure and evaluate programs

Identify and spread innovation

Provide providers data they need to transform health care delivery

Support the health data ecosystem with CMS data and information resources to accelerate system transformation

DATADATADATA

CMS is announcing a new office to make data and information a core function of the agency!

Office of Information Products & Data Analytics

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Goal 1Clarify data use &

dissemination authorities

Goal 2Improve data

content & organization

Goal 3Improve data access & user

experience

Goal 4 Develop more timely

and relevant information products

Goal 5Leverage data

and information to maximize impact

Policy Actions

Data Actions

●Aggregate Medicare data in an easy-to-use format for key metrics at the State and Hospital Referral Region levels

● Include demographic, spending, utilization, and quality of care indicators for Medicare across four years (2007-2010)

●Available online on the Institute of Medicine website and will be available in the Health Indicators Warehouse in July 2012

Medicare Geographic Variation Trend Data

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Change in ED Visits per 1,000 Beneficiaries (2007-2010)

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National ED Visits per 1,000 Beneficiaries

2007 622 2008 636 2009 645 2010 658

Change in All-Cause Hospital Readmission Rates(2007-2010)

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National Readmission Rate

2007 19.2% 2008 19.3% 2009 19.4% 2010 19.2%

2011 (prelim.) 19.0%

Change in Per-Capita Spending (2007-2010)

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National Per-capita Spending

2007 $8,586 2008 $9,058 2009 $9,527 2010 $9,732

Medicare Data Sharing for Performance Measurement

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Qualified Entity

INSURANCE COMPANIES MEDICARE?

NOW FUTURE

COMPREHENSIVE

CONSISTENT

FAIR

ACTIONABLE

INSURANCE COMPANIES MEDICARE?

●VA, DoD and CMS effort to give patients access to their own data (FEHB plans beginning to also offer blue button)

● 300,000 CMS beneficiaries have downloaded their data to date

● 2012 enhancements Moving from 1 year of data to 3 years of data

Moving from Parts A and B data to Parts A, B and D data

Blue Button Data

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Recent Articles:

● “Physician Willingness and Resources to

Serve More Medicaid Patients: Perspectives

from Primary Care Physicians”

● “Noncompliance in the Use of Cardiovascular

Medications in the Medicare Part D Population”

● “Flu shots and the characteristics of

unvaccinated elderly Medicare beneficiaries”

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Medicare & Medicaid Research Review

CMS’s online, peer-reviewed journal that informs current and future directions of Medicare, Medicaid and CHIP!

Why authors should publish in MMRR?

Highly Visible - on CMS web, indexed in PubMed, reaches key policy makers Accessible - research is freely available to anyone with an internet connection No Use Restrictions - in the public domain, so it can be copied and used freely Ease Of Publication - publishes continuously; online submission & peer review

●Single location with comprehensive statistics on Medicare enrollment (Parts A, B, and D and Medicare Advantage)

● Information at national and state level for recent years and historical Medicare enrollment trends beginning in 1966

Medicare Enrollment Dashboard

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