About This BlogThe SW Health Law Checkup is written by the attorneys of Snell & Wilmer to provide their insight on an array of regulatory and compliance matters related to federal and state fraud and abuse laws and regulations, reimbursement, credentialing and employment of providers, joint ventures and physician-entity integration, best practices in compensation and contracting, value-based purchasing and contracting with providers.
On July 1, CMS finalized new MACRA rules that significantly expand how qualified data entities will be allowed to share or sell analyses of Medicare and private claims data to providers, insurers, employers, and others who, in turn, can use the data to support improved care. In announcing the new rules, CMS’ Chief Data Officer, Niall Brennan, stated that “ncreasing access to analyses and data that include Medicare data will make it easier for stakeholders throughout the healthcare system to make smarter and more informed healthcare decisions.” The goal of the program is that through data analytics, organizations will be able to identify and implement improvements to clinical practice standards and population health strategies. In fact, MACRA’s new advanced alternative payment models, which require physician groups to assume greater downside financial risk, would likely benefit from any improvements to population health strategies that are derived from this new data mining initiative. CMS also hopes that these new rules will increase the number of organizations that are interested in its qualified entity program. Currently, there are 15 certified qualified entities, although CMS noted in the final rule that only 2 qualified … Continue reading
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