By – The Centers for Medicare & Medicaid Services (CMS) increased public access to Medicaid and CHIP data through the release of Transformed Medicaid Statistical Information System (T-MSIS) data.
This marks continued commitment from CMS to promote transparency and accountability in the Medicaid program through data sharing, according to CMS Administrator Seema Verma.
“The research community and stakeholders will have a powerful tool to provide creative solutions on Medicaid and CHIP healthcare delivery, outcomes, and financing,” Verma said in a statement.
This comes as part of the MyHealthEData initiative, unveiled in March 2018, which aims to reveal data to the public to promote data-driven solutions, help ensure sound program performance, support improvement, and identify and prevent fraud, waste and abuse in the Medicaid and CHIP programs.
The release of the T-MSIS data will allow medical providers and researchers to analyze data and identify what states and the federal government are paying for Medicaid and CHIP services.
T-MSIS includes information on utilization and spending under Medicaid managed care that can enable research and analysis to improve quality of care, assess beneficiary care costs and enrollment, and to improve program integrity.
And, ultimately, it should help industry leaders and providers to make better decisions about patient care and population health.
The availability of the data also allows monitoring and oversight of Medicaid and CHIP programs, to enable evaluation of demonstrations under section 1115 of the Social Security Act, and to calculate quality measures and other metrics, CMS stated.
“By unleashing data, the Trump Administration is establishing an environment of shared learning and opportunity for federal and state partners to continue to realize values from best practices, leading to positive health outcomes for our most vulnerable populations,” Verma explained.
As a result of the five years that CMS invested into finding transparency at the two programs, the company now possesses timelier beneficiary-level data on the Medicaid and CHIP programs than ever before.
CMS is continuing to work with states to improve reporting to ensure that future data releases will be even better.
This move comes as CMS continues its work to address data exchange. While this latest data release will help providers and medical researchers, previous actions aim to promote the free flow of patient data between the providers who treat them.
In February, CMS set out to get tough on “bad actors” contributing to health information blocking.
Following the announcement of the Interoperability and Patient Access Proposed Rule, Verma told the media that the federal agency would publicly identify providers who prevent health data sharing.
“We’re also putting an end to information blocking. The days of holding a patient’s data hostage are over,” she stated.
“Our proposed rule includes a policy to publicly identify doctors, hospitals, and other healthcare providers who engage in information blocking,” Verma said in February. “Simply put, we’re going to expose the bad actors who are purposefully trying to keep patients from their own information. Patient data doesn’t belong to the doctor, hospital, or electronic health record. It belongs to the patient.”
As part of a condition for receiving full Medicare reimbursement, eligible providers will have to attest whether they have participated in information blocking as part of the Merit-based Incentive Payment System (MIPS).
“There are three questions related to information blocking. If they answer yes to one of those, we will be publishing that data,” continued Verma.
Under the rule, hospitals are required to send electronic notifications to providers when patients are admitted, discharged, and transitioned (ADT) to the hospital.
“Increasing quality and driving down costs requires an informed care team,” Verma said earlier this year. “Using the strongest lever we have — making it a condition of participation in Medicare — we are requiring that all hospitals must send electronic notifications to designated healthcare providers when their patients are admitted, discharged, or transferred from the hospital to improve transitions of care between medical settings [and] to increase patient safety, coordination, and improve overall care.”