CMS Announces Entrepreneurs and Innovators to Access Medicare Data

At Health Datapalooza, the acting Centers for Medicare & Medicaid Services (CMS) Administrator, Andy Slavitt, announced a new policy that for the first time will allow innovators and entrepreneurs to access CMS data, such as Medicare claims. As part of the Administration’s commitment to use of data and information to drive transformation of the healthcare delivery system, CMS will allow innovators and entrepreneurs to conduct approved research that will ultimately improve care and provide better tools that should benefit healthcare consumers through a greater understanding of what the data says works best in health care. The data will not allow the patient’s identity to be determined, but will provide the identity of the providers of care.

CMS will begin accepting innovator research requests in September 2015.

“Data is the essential ingredient to building a better, smarter, healthier system. The announcement is aimed directly at shaking up health care innovation and setting a new standard for data transparency,” said acting CMS Administrator Andy Slavitt. “We expect a stream of new tools for beneficiaries and care providers that improve care and personalize decision-making.”

Innovators and entrepreneurs will access data via the CMS Virtual Research Data Center (VRDC), which provides access to granular CMS program data, including Medicare fee-for-service claims data, in an efficient and cost effective manner. Researchers working in the CMS VRDC have direct access to approved privacy-protected data files and are able to conduct their analysis within a secure CMS environment.

“Historically, CMS has prohibited researchers from accessing detailed CMS data if they intended to use it to develop products or tools to sell,” said Niall Brennan, CMS chief data officer and director of the Office of Enterprise and Data Analytics. “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.”

Examples of tools or products that innovators and entrepreneurs might develop include care management or predictive modeling tools, which could greatly benefit the healthcare system, in the form of healthier people, better quality, or lower cost of care. Even though all data is privacy-protected, 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.

CMS is also announcing that all researchers will be allowed to request data on a quarterly basis rather than the annual updates that were available in the past. Technological advancements, such as the VRDC, have facilitated access to more current data without higher data costs.  This change in data access will allow researchers to conduct more rapid analysis of the delivery system.

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