ACOs aren’t getting all the Medicare data they need either

A reader tipped me off to this letter from the National Association of ACOs.

If the federal government is unwilling to reform patient consent for the purposes of an ACO’s ability to provide adequate care coordination we would recommend related claims data be provided ACOs as de-identified. This would at least allow ACOs to create better patient population profiles, enable ACOs to develop more effective programming and allow them to better manage costs or increase their accountability for costs.

I haven’t chased down everything related to this, but it seems that ACOs aren’t receiving substance use disorder-related claims and don’t have other feasible ways to obtain the information they would convey.

This is problematic because ACOs are responsible for clinical and cost outcomes for all patients, not just those without substance use diagnoses. And, ACO patients can obtain care from other providers, outside the ACO. So, how is an ACO supposed to plan and improve population care if it can’t obtain all the relevant information about their population?

This is an important question. It is related to the one I’ve been asking about research data scrubbed of substance use-related claims. But, I should emphasize that these two issues, though related, are different. The National Association of ACOs is asking for de-identified Medicare data. Researchers often need identified Medicare and Medicaid data (e.g., to merge with that from other systems, like the VA). For this very reason, there are data security protocols in place for proper handling of research data.


Hidden information below


Email Address*