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Clinical Registry Groups Push for Greater Access to Medicare Claims Data

By jfellows@healthleadersmedia.com  
   April 21, 2016

It's true that ResDAC is a channel for organizations to get the information in question, but Jacobs and others say ResDAC isn't a true alternative to the Medicare claims data spelled out in MACRA.

"It's difficult to access and the data quality is not as good as it could be," says Jacobs.

Former director of CMS's Center for Medicare Management Jeffrey Rich, MD, agrees. Rich, who is past president of STS and currently serves on the board of directors of Virginia Cardiac Surgery Quality Initiatives (VCSQI), says there are several drawbacks to using data from ResDAC.

"It's cumbersome," he says. "You have to apply, qualify, submit your proposal, ask for the data, then pay a fee. And your file upload capabilities are limited to 50 gigabytes; that's not a lot of data."

In response to CMS's interpretation, Portman wrote a letter on behalf of PCRC pointing out that ResDAC's purpose is for research that uses separate, distinct datasets. MACRA's intent is to link value, cost, quality, and outcomes, which calls for much more dynamic analysis.

"Registries need continuous access to improve the power of their databases," Portman says.

The kind of access that Jacobs and other medical societies want is something that Rich has through VCSQI, a consortium of more than 30 hospitals and cardiac surgery centers in Virginia. The group has worked together since 1996. The 18 VCSQI hospitals share their Medicare claims data with 14 participating cardiac surgical practices.

"Once we get the data back, we do our own aggregation," Rich says. "It's like getting a box of tax receipts at the end of the year to interpret. We hire an IT company, and to do that on annual basis is a quarter of a million dollars. We have a huge infrastructure to do this, but it's really what we need."

By combining Medicare claims data with clinical data, cardiac quality, outcomes, and cost in Virginia have improved. As a result of sharing data, VCSQI developed a standard protocol for reducing post-operative atrial fibrillation. It has also reduced blood transfusions, saving the state at least $44 million. Now the consortium is working on reducing readmissions, Rich says.

"To get this data and match it to our clinical data is the golden egg," he says. "We've proved there is value in doing it, but nobody can do what we do because of the barriers. That's why we pushed Congress hard for access to the data. It's crucial for value-based purchasing."

Jacqueline Fellows is a contributing writer at HealthLeaders Media.


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