CMS Gives Health Care Cost Institute Access to Medicare Claims Data

July 10, 2014 in News

CMS has certified the Health Care Cost Institute as the first “Qualified Entity” to have complete access to national Medicare claims data, Health Data Management reports (Slabodkin, Health Data Management, 7/8).


The Medicare Qualified Entity program allows organizations to access and analyze Medicare data for certain reasons (iHealthBeat, 11/26/13). Created under the Affordable Care Act, the program allows selected groups to bring together Medicare Parts A, B and D claims data, as well as data from other payers, to assess the performance of:

  • Providers;
  • Services; and
  • Suppliers.

Details of HCCI Certification

As a qualified entity, HCCI will have full access to all Medicare Parts A and B claims data and roughly 40% of claims data from Medicare Part D. According to Health Data Management, HCCI currently has access to about 40% of data from Medicare Part C’s managed care population (Health Data Management, 7/8).

In a release, the institute said, “The addition of comprehensive Medicare claims data will now afford HCCI a unique and unprecedented opportunity to track and publicly report on health care trends using both public and commercial data.”

HCCI added that the Medicare data “will be a powerful addition to the HCCI transparency initiative, providing essential information to help us better understand what is needed to improve the quality and performance of the U.S. health system” (HCCI release, 7/8).

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