CMS hopes Medicare Advantage data will improve seniors’ health care

Written on May 01, 2018

The Centers for Medicare & Medicaid Services (CMS) has released Medicare Advantage data to researchers in an effort to help them better understand care trends for seniors.

This is the first time the agency has released the data to researchers. The agency has been collecting data on patient conditions and the services they receive since 2012, using it to help calculate payments for Medicare Advantage insurers.

The agency has now released preliminary Medicare Advantage encounter data from 2015. More data is expected to come in from insurers through August, and final data reports will follow that. The CMS will release data on MA enrollees annually going forward.

Researchers will have to sign a data use agreement with the Research Data Assistance Center to gain access to the 2015 Advantage data.

The CMS had expected to make Medicare Advantage plan data available last year, but data quality and accuracy concerns postponed the release.

Next year, the CMS also expects to make Medicaid and Children's Health Insurance Program data available, giving researchers access to data on another 70 million patients.

Policy insiders have pushed the CMS to release Medicare Advantage data, noting there has been little public information on the value Medicare Advantage provides to its beneficiaries.

"Taxpayers deserve to know how their money is being spent, considering that Medicare Advantage plans receive substantial payments from the federal government and provide care for a significant and growing proportion of beneficiaries," former CMS Chief Data Officer Niall Brennan and health economist Austin Frakt said in an article published in The Journal of the American Medical Association.

Medicare Advantage enrollment increased from 13% of the Medicare population, or 5.3 million individuals, in 2004 to almost 33%, or 19 million individuals, in 2017. Government payments to Medicare Advantage plans have increased from $77 billion to more than $200 billion per year over the same period, according to researchers.

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