CHICAGO, June 12, 2019 /PRNewswire/ -- Blue Health
Intelligence® (BHI®), a leader in healthcare
analytics, has been named a certified Qualified Entity (QE) by the
Centers for Medicare & Medicaid Services (CMS). With this
distinction, BHI will gain access to all Medicare fee-for-service
(FFS) claims for acute care, post-acute care, physician office, and
pharmacy services for more than 59 million individuals each
year.
Based on the scale and breadth of its existing commercial claims
data, BHI will have access to CMS data from all 50 states and the
District of Columbia. Through its
CMS partnership, which is also known as the Medicare Data Sharing
for Performance Measurement Program, BHI will combine FFS Medicare
data with its already rich set of commercial claims from 190+
million unique individuals and 19+ billion claims. Based on
provisions specified by CMS, BHI will produce provider quality and
other reports to address healthcare's triple aim – better care for
individuals, better health for populations, and lower costs for
all.
"We are honored to become a member of the QE program," said
Swati Abbott, BHI's CEO. "By
combining this critical healthcare data with our advanced analytics
and transparent methodologies, BHI can share a complete
understanding of provider cost and quality across the U.S. We will
also be able to produce clinically and statistically valid
healthcare insights for every condition, age group, and
geography."
BHI's access to this combined data will also help answer key
research and business questions by:
- Examining care utilization patterns by various population
characteristics to see which sites of care and/or policies lead to
the best health outcomes
- Understanding the effect of value-based payments on provider
and consumer behavior
- Determining which initiatives and interventions improve care
quality and lower costs
"As data scientists, clinicians, technologists, and business
leaders who work side-by-side with health plans, providers,
academics, employers and other stakeholders, BHI can't wait to get
started as a QE to help make healthcare better," Abbott said. "With
access to Medicare Parts A, B and D data, BHI can further realize
our mission to provide transformational insights on cost, quality,
and outcomes."
Under its three-year certification, BHI will release its first
public provider performance report within one year of receiving
Medicare data.
About Blue Health Intelligence®
Leveraging the power of medical and pharmacy claims data from
more than 190 million Americans, Blue Health Intelligence (BHI)
delivers insights that empower healthcare organizations to improve
patient care, reduce costs, and optimize performance. Our team of
data analysts, clinicians, IT experts, and epidemiologists provide
analytics, software-as-a-service, and in-depth consulting to
healthcare stakeholders. Blue Health Intelligence is an independent
licensee of the Blue Cross Blue Shield Association and carries the
trade name of Health Intelligence Company, LLC.
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SOURCE Blue Health Intelligence