Policy & Regulation News

CMS Calls for Patient-Centered Data Access in New Agency Initiative

The agency announced the launch of the Data Driven Patient Care Strategy, which will enable patient-centered data access.

patient-centered data access

By Sara Heath

- CMS will be putting patients at the center of healthcare decisions as a part of the Data Driven Patient Care Strategy, an offshoot of the MyHealtheData initiative, CMS Administrator Seema Verma announced this week at the 9th annual Health Datapalooza.

The Data Driven Patient Care Strategy has a three-pronged approach, Verma explained. First, CMS aims to put the patient at the center of healthcare. Next, the agency will focus on making more health-related data available to patients. CMS will also take an “application programming interface (API)-approach” to improving patient data access.

“We know we can’t achieve value-based care until we put the patient at the center of our healthcare system,” Verma explained in a public statement about the Data Driven Patient Care Strategy. “The Data Driven Patient Care Strategy will empower patients with the information they need as consumers of healthcare to enable them to make informed decisions about the care they need. Ultimately, the cornerstone of a patient-centered system is data—quality data, cost data and a patient’s own data.”

This initiative will encompass all of the patient-centered initiatives CMS has launched in recent months, including the MyHealtheData initiative.

For example, the Blue Button 2.0 project uses APIs to allow patients to access their own claims data and to choose which providers with whom they will share that data.

READ MORE: CMS Calls for Hospital Price Transparency Mandates in Proposed Rule

CMS has also urged Medicare Advantage plans to adopt the Blue Button 2.0 approach for their patients.

The agency has also made calls for better price transparency for patients, helping them to make better care decisions based off of what is valuable to them. Medicare hospitals will now be required to post their charge lists online for patients to access.

Underlying all of these patient-centered efforts are principles of health data security. Data security is an important aspect of patient-centered care because it is essential for protecting the patient, Verma said.

“And just as important as controlling our health data, we should know how it’s being used at all times,” Verma asserted in a transcript of her speech. “As we’re all aware, the privacy and security of our data has recently become a universal concern, and necessary protections must be a priority, not overlooked, ignored, or disregarded.”

The time is ripe for making such pushes, Verma noted. While the healthcare industry has been getting its toes wet with patient centricity and patient data access, medical professionals are now recognizing how essential the patient is to the entire value-based care puzzle.

READ MORE: CMS Initiative Aims to Improve Patient Access to Health Data

 “What is different now is that we know we can’t achieve value-based care until we put the patient at the center of our healthcare system,” Verma said. “And that requires that we empower patients with the data they need to become a consumer of healthcare and make informed decisions. Ultimately, the cornerstone of a patient centered system is data, quality data, cost data, a patient’s own data.”

CMS is making these current pushes because healthcare organizations are currently falling short, Verma stated.

“Current systems don’t enable easy access to all the data we need…all the data that researchers need, or that our healthcare system needs,” she contended. “We all know this, as we all still have to fill out the same forms at each doctor’s visit.”

Medical organizations have made concerted efforts to put more data back into the hands of the patient, Verma conceded. However, the new CMS programs call for making that data usable and putting data into context.

“And it’s not just about being able to get our records—but having all the data and being able to utilize and share them in the best way possible,” she noted.

READ MORE: How Patient Portals Improve Patient Engagement

Verma also announced that Medicare Advantage encounter data will now be available to healthcare researchers, for the purposes of those researchers innovating strategies for improving Medicare Advantage care encounters for patients.

Researchers will now be able to access encounter data from patient care experiences starting in 2015. The agency has similar plans for Medicaid and CHIP data, allowing researchers to develop better care strategies in those programs as well. Verma did not indicate when those changes for Medicaid and CHIP would occur.

While researchers currently have access to Medicare claims data for fee-for-service encounters, CMS says this move will provide researchers a broader view of the Medicare patient experience.

“Data has the potential to help produce better, more targeted treatments for patients, improving their quality of life while at the same time reducing costs,” Verma noted.


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