The Centers for Medicare & Medicaid Services are attempting to identify a central data source across government for collecting information on the most vulnerable populations to ensure health equity.
Some Medicare and Medicaid quality programs already collect demographic data like race, but it’s not standardized across government.
The COVID-19 pandemic exposed gaps in health care nationally, and CMS wants to put the demographic data at its disposal into a central data repository so authorized users can access it to address disparities in its programs.
“What we feel as though we need to do is actually look for another agency, and I hate to pick on the Social Security Administration but everybody has a Social Security Number,” said Mark Plaugher, deputy director of the Information Systems Group within the Center for Clinical Standards and Quality, during the AFCEA Bethesda Health IT Event on Thursday. “The higher up where we can find those common denominators is the way to actually collect that information.”
In the meantime CCSQ is improving cross-program analytics so data collected by systems like the Hospital Inpatient Quality Reporting Program’s can support other programs.
CMS partnered with states to share Medicaid data near real time to identify forgone care, preventative services that children are missing out on, declines in dental and behavioral health services, and an increased need for substance use disorder treatment during the pandemic.
The agency launched the first Medicaid and CHIP Financial (MACFin) system module last weekend to automate monitoring and approvals of state spending of the program’s $670 billion.
“That is huge because right now we have a lot of people doing a lot of manual labor in that space,” said Karen Shields, deputy director of the Center for Medicaid and CHIP Services. “And so we look for this system to be one of the major improvements in our service delivery in a long time.”
The Transformed Medicaid Statistical Information System (T-MSIS) gathers all Medicaid data and converts it into readable files for researchers and other users, providing a national view of how the program is being used — including inequities in how people obtain benefits.
CMS is in the process of building a Medicaid and Children’s Health Insurance Program (CHIP) data warehouse and using Data Connect to link sources for ease of use.
The agency is also merging Medicare and Medicaid data to get a complete picture of dual eligibles but still needs a system for understanding whose benefits were terminated during public health emergencies and where they went, which remains “a big question mark” for CMS, Shields said.
“The whole concept is not to just have a data storehouse,” she said. “But to have a place where stories can be built and told and understood and used to help.”