U.S. Senators Tammy Baldwin (D-WI) and John Thune (R-S.D.) today introduced bipartisan legislation that increases the transparency of healthcare costs in Medicare - helping doctors, health systems, private insurers, and research institutions provide more efficient, higher quality healthcare and better patient outcomes.
“Medicare is the single largest payer of healthcare services in the country, spending over $600 billion each year. But we have very little access to what we are paying for,” said Baldwin. “The Quality Data, Quality Healthcare Act provides access to that data and puts it into the hands of those who can use it, increasing efficiency in the delivery of healthcare and helping us get better bang for our healthcare buck.”
“Providing access to data that can be used to evaluate healthcare services is a critical component of increasing transparency and reducing healthcare costs,” said Thune. “Our bill would ultimately provide data to evaluate the areas of healthcare that are working and those that are not, thereby lowering costs and increasing efficiency. I hope our colleagues will join us in supporting this common-sense measure to improve the quality of healthcare while reducing costs.”
As the largest payer of healthcare in the United States, the Centers for Medicare and Medicaid Services sits on a wealth of information that can help inform healthcare providers in making better decisions that will improve patient care and reduce costs. Economists have argued that expanding access to Medicare cost and utilization data will increase efficiency in healthcare delivery, reduce costs, and improve the quality of care.
Congress and the administration have taken initial steps to make Medicare data more widely available. One of the more promising efforts is the Qualified Entity (QE) program, which permits organizations to access and analyze Medicare data for select purposes. The QE program has the potential to empower our nation’s healthcare decision-makers to make better choices. However, current law is far too restrictive on which organizations can participate in the QE program; what QEs can do with the Medicare data once they have received it; and the degree to which QEs can support their own data maintenance infrastructures.
The Quality Data, Quality Healthcare Act would provide for greater access to Medicare claims data by modernizing and reforming the QE program. The legislation would:
•Allow organizations receiving Medicare data to analyze and redistribute it to authorized subscribers (insurers, health systems, and physicians) so that subscribers can make more informed decisions; and
•Permit those entities to charge a fee to their subscribers so that the organizations can conduct robust analyses to improve healthcare quality and reduce costs.Organizations from across the political spectrum support Baldwin and Thune’s “much-needed” efforts to reform the QE program, including: Council for Affordable Health Coverage, National Coalition on Health Care, AARP, Blue Shield of California, The Boeing Company, Castlight Health, Caterpillar Inc., Communicating for America, Community Catalyst Compass Healthcare Advisors, Corporate Health Care Coalition, The Dow Chemical Company, Health Care Cost Institute HR Policy Committee, National Association of Health Underwriters, National Association of Manufacturers, National Retail Federation Pacific Business Group on Health, Midwest Business Group on Health, U.S. PIRG, UPS, Xerox Corporation.