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    SCAI Speaks on Medicare Data for Performance Measurement

    October 01, 2010

    SCAI and its partners in the Alliance of Spcialty Medicine offered feedback earlier this week on Section 10332 of the Patient Protection and Affordable Care Act, which requires the Secretary of the Department of Health and Human Services to make claims data available to qualified entities for the evaluation of the performance of providers on measures of quality, efficiency, effectiveness, and resource use.

    In comments to CMS Administrator Dr. Donald Berwick, the Society reiterates its support of efforts to help physicians better understand the quality and cost of their care and to provide them with tools that will allow for the continuous improvement of care. However, the Society cautions CMS to move carefully in implementing programs that result in public reporting of performance data and that rely solely on claims data to make such determinations.

    The Society also offered the following guidance/suggestions:

    • Qualified entities must submit a description of the methodologies it will use to evaluate the performance of providers and suppliers;
    • Use standard/endorsed measures, or alternative measures if the Secretary so determines;
    • Include data made available under this subsection with claims data from other sources in the evaluation of performance of providers of services and suppliers;
    • Only use data made available, and information derived from, an evaluation of the performance of providers and suppliers for the reports required by this provision;
    • Include in the reports an understandable description of the measures, risk adjustment methods, physician attribution methods, other applicable methods, and data specifications and limitations;
    • Receive prior review by the Secretary of the format of proposed reports;
    • Make the information available confidentially, to any provider or supplier prior to the public release of such report; and
    • Only include information on a provider of services or supplier in aggregate form.