Researchers are up in arms against a plan to restrict access to Medicare and Medicaid data by the Centers for Medicare and Medicaid Services (CMS), which oversees Medicare and Medicaid. The CMS plan will make it harder for researchers to access and analyze Medicare and Medicaid data as they please. This data is critical for understanding what’s working and not working in our health care system for different populations and in different geographic areas, explains Ge Bai, a professor of accounting and health policy at Johns Hopkins in Forbes.
Medicare and Medicaid data reflects health care usage by 4o percent of insured Americans, allowing researchers to report on how well our health care system is working for different populations. But, CMS just announced that it’s ending the ability of institutions to use Medicare and Medicaid data freely, easily and inexpensively. Rather, it will charge more for this data and impose many more restrictions on its use. CMS plans to begin this new policy in 10 weeks.
As it is, CMS is not collecting key Medicare Advantage data that would help researchers better understand the care people are receiving in their Medicare Advantage plans.
Bai outlines three serious implications of this new CMS plan.
- It will be harder for researchers to study Medicare and Medicaid, so less research will occur. This will limit government accountability and shield CMS from public scrutiny. We need external oversight to ensure CMS ensures Medicare and Medicaid are working as well as possible. External analysis of data will always add a new array of insights and solutions for improving Medicare and Medicaid and the health of older adults and people with disabilities and low incomes.
- It will end a lot of research by independent entities. Already today it is too expensive for smaller entities to access CMS data. The administration will control the narrative about the data.
- Cronies will benefit from requiring the purchase of data at a high price from CMS.
CMS claims that it is concerned about data breaches but has not indicated that researchers’ use of the data has led to breaches. Moreover, CMS could easily do more to minimize the likelihood of breaches without restricting access to data and harming the public good.
CMS is undermining data transparency in its own agency at the same time that it is requiring more transparency from hospitals and other health care stakeholders. How does this promote competition?
CMS claims to own the Medicare and Medicaid data, but in truth the public owns it. CMS is charged with collecting data. But, the public cannot assess CMS’ work without access to the data. Of course, it can be deidentified.
For the good of Medicare and Medicaid and the people who benefit from it, CMS should make all its data easily available to researchers at a fair price.
Here’s more from Just Care:
- Bi-partisan group of Senators call for better Medicare Advantage data to protect enrollees
- Sen. Warren and Rep. Jayapal urge CMS to end Medicare Advantage overpayments, punish bad actors
- Medicare Advantage: Combating fraud is a challenge because there’s no data on denied claims
- Medicare Advantage plans fail to release data required for oversight
- Data show Medicare Advantage covers less nursing, rehab, home health care
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