A storm is brewing in Washington over the best way for Medicare to share information that can improve care and support value-based purchasing. While there are probably as many opinions about uses of Medicare data as there are lobbyists in the Beltway, two approaches seem to be getting the most attention.
Senators Ron Wyden (D-Ore.) and Charles Grassley (R-Iowa) have introduced legislation that would require Medicare to put claims information on a searchable public database for anyone to use. While I am an ardent fan of better access to Medicare data, I worry that more data does not equal more information. In Minnesota, we have shown that to get the data used for improvement, we must help people focus on measures that can have the greatest impact; show how the information can be used to get better results; align our measures so patients and providers get consistent messages about their results; and use methods that patients and providers believe are credible. The proposed new website may be a distraction without some supports in place to ensure that the information is used in consistent ways that will benefit patients.
Another proposal is attempting to address the need for aligned and credible measures. Stand for Quality, a large alliance of stakeholders who support health care performance measurement and reporting, is promoting federal funding for the National Quality Forum to endorse a standardized set of measures that can be used by Medicare and other purchasers. We support a stronger process for national endorsement of measures that would yield better measures and get more alignment between Medicare and other payers, but this approach alone doesn’t address how to use the measures for improvement. Even with endorsed measures, patients and providers need a trusted place to share their data and get results that are meaningful. That trust is much easier to build at a community level. The proposal would be much stronger if it included a role for regional collaboratives, such and MN Community Measurement, that have experience in developing high-value measures and getting the measures used for improvement at the local level.
I am most encouraged by language in the 2013 Budget Reconciliation Act that allows Medicare to recognize providers who use data registries to meet certain requirements for Medicare measurement and reporting. This change could open the door for Medicare to benefit from the measurement work already being done by providers in Minnesota through MN Community Measurement and would reduce the burden of measurement and increase the impact for Medicare patients and the community.
We will keep you posted on the progress of these discussions with Medicare. Please let us know if you have ideas about how we could work together to get greater recognition of Minnesota’s measurement efforts.
I hope you have a great rest of your summer.
View this article and others in The Measurement Minute – August 2013 newsletter.