Health Care Reform Rules Would Restrict Public Reporting

Proposed government rules could prevent consumer groups from getting performance data from health care facilities and would give medical providers the right to review any findings in advance.

It’s estimated that hundreds of thousands of patients die annually from preventable harm suffered while undergoing medical care. The infections, injuries and errors could rank as a leading cause of death in the United States.

Last year’s sweeping health care reform law – the Patient Protection and Affordable Care Act – promised to improve the problem by allowing outside groups to use Medicare billing records to analyze and publicly report on the quality of care. But proposed rules that would guide the release of the data are being criticized by consumer groups, who say they will make independent accountability impossible.

The rules being developed [1] by the Centers for Medicare & Medicaid Services (CMS) propose restricting the release of Medicare billing data to “qualified entities.” To qualify, a group would have to:

• Pay up to $200,000 for the data.
• Have their methods pre-approved before obtaining the data.
• Already possess billing information from other sources to combine with the Medicare data – an advantage to insurance companies.
• Limit public reporting to quality measures approved by the health care industry.
• Present their reports and findings to every doctor and facility being measured before they are released to the public – which would make large-scale reports difficult.

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