Quality Data, Quality Healthcare Act Promotes Informed Healthcare Decisions Leading to Better Patient Outcomes
Washington D.C. – 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.
“The Wisconsin Medical Society applauds Senator Baldwin for the introduction for the Quality Data, Quality Healthcare Act. We find ourselves in the midst of a time of great challenges and of great changes in healthcare delivery and payment. As we proceed with the exciting transition from a payment system that is driven by volume, to a payment system that will be driven by value, reliable, accurate and comprehensive data will be the key to optimizing our success. The Quality Data, Quality Healthcare Act will provide physicians and the organizations that represent them, easier access and use of Medicare data to improve healthcare quality and patient outcomes, to improve the health of the public and to reduce healthcare costs , thereby achieving a truly value-based healthcare delivery and payment system for our nation.” -Rick Abrams, Wisconsin Medical Society
“We have been improving healthcare by reviewing health insurance claims data in Wisconsin since 2009. However, we have not been able to include Medicare claims data, one of the most important data sources for understanding healthcare utilization, quality and costs, in our process. Senator Baldwin's bill removes a huge barrier in our ability to improve care. I applaud Senator Baldwin's vision and leadership, and her commitment to improving the quality of healthcare for all Americans.” -Dr. John Toussaint, CEO, ThedaCare Center for Healthcare Value
“The Wisconsin Health Information Organization (WHIO) commends Senator Tammy Baldwin for her work to expand access to Medicare data, and supports the introduction of the Quality Data, Quality Healthcare Act. WHIO uses health claims data to improve patient care in Wisconsin through increased transparency of healthcare quality and cost. Currently, WHIO only has access to private payer claims and Medicaid data. With Senator Baldwin’s effort to make Medicare data more fully available, WHIO will have a more complete picture of quality and cost which it will use to better inform patients, employers, insurers and healthcare providers in Wisconsin. WHIO commends and thanks Senator Baldwin for her efforts to improve quality and reduce costs in Wisconsin.” -Josephine Musser, CEO, Wisconsin Health Information Organization
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, 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.