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Rule Gives Providers/Employers Improved Access to Information for Better Patient Care

July 6, 2016

MACRA provides expanded opportunity for the use of Medicare and private sector claims data to drive higher quality, lower cost care

On July 1, CMS finalized new rules that will enrich the Qualified Entity Program by expanding access to analyses and data that will help providers, employers, and others make more informed decisions about care delivery and quality improvement. The new rules, as required by the Medicare Access and CHIP Reauthorization Act (MACRA), allow organizations approved as qualified entities to confidentially share or sell analyses of Medicare and private sector claims data to providers, employers, and other groups who can use the data to support improved care. The rule also includes strict privacy and security requirements for all entities receiving patient identifiable and beneficiary de-identified analyses or data.

Qualified entities must combine Medicare data with other claims data (e.g., private payer data) to produce quality reports that are representative of how providers and suppliers are performing across multiple payers.

Final Rule

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