Policy and Regulation News

CMS Releases Medicare Advantage Encounter Data to the Public

CMS will release Medicare Advantage encounter data to increase transparency and allow consumers to make better healthcare choices.

CMS will release Medicare Advantage encounter data.

Source: Thinkstock

By Thomas Beaton

- CMS has planned to release Medicare Advantage encounter data so that researchers and consumers have the ability to make informed opinions about the cost and healthcare outcomes of the MA program.

The agency will allow researchers to access 2015 Medicare Advantage dataset, which include provider identifiers, dates of services, diagnosis codes, and information about healthcare settings where services were performed.

MA beneficiaries will now be able to access their claims information and share it via CMS’s Blue Button 2.0 Program.

CMS Administrator Seema Verma said the agency will provide updated Medicare Advantage data and release CHIP data that contains information on over 70 million beneficiaries.

“We recognize that the MA data is not perfect, but we have determined that the quality of the available MA data is adequate enough to support research,” Verma said during a speech at the 2018 Health Datapalooza event. “And although this is our first release, going forward, we plan to make this data available annually.”

The announcement is just one part of CMS’s Data Driven Patient Care Strategy, an overarching initiative to increase transparency and allow stakeholders to engage more fully with CMS data assets.

Verma’s speech follows up on the agency’s efforts to enhance consumer price transparency across CMS programs and equip consumers with data and insights for choosing affordable and high-quality healthcare options. CMS believes consumer transparency is a critical piece of the transition towards value-based care.

“We know we can’t achieve value-based care until we put the patient at the center of our healthcare system,” Verma explained.

“The Data Driven Patient Care Strategy will empower patients with the information they need as consumers of healthcare to enable them to make informed decisions about the care they need. Ultimately, the cornerstone of a patient-centered system is data—quality data, cost data and a patient’s own data.