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CMS Expands Access to Claims Data

June 3, 2015
by Gabriel Perna
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The Centers for Medicare and Medicaid Services (CMS) is opening up its claims data for private entrepreneurs and researchers to use more frequently, the agency announced this week at Health Datapalooza.
The new policy will allow entities to submit research requests to use the data to improve the healthcare system. The researchers will be allowed to make the requests on a quarterly basis. Traditionally, any claims data available from CMS has only been available on an annual basis.
Once their requests are approved, the innovators will have access in CMS' new Virtual Research Data Center (VRDC). The VRDC will include granular CMS program data, such as Medicare fee-for-service claims data. Researchers working in the VRDC will have direct access to approved privacy-protected data files, which does not include patient identity. However, it will include the provider's identity.
CMS notes that researchers also will not be allowed to remove patient-level data from the VRDC. They will only be able to download aggregated, privacy-protected reports and results to their own personal workstation.
“Historically, CMS has prohibited researchers from accessing detailed CMS data if they intended to use it to develop products or tools to sell,” Niall Brennan, CMS chief data officer and director of the Office of Enterprise and Data Analytics, said at Health Datapalooza. “However, as the delivery system transforms from rewarding volume to value, data will play a key role. We hope that this new policy will lead to additional innovation and insights from the CMS data.”
The announcement is part of CMS' open data movement. Earlier this week at Health Datapalooza, it published its physician and supplier utilization and payment data for the second straight year. 


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