CHA News Article

CMS Certifies California Organization to Collect and Disseminate Provider Health Care Data
New system will combine Medicare and commercial data for performance ratings

The Centers for Medicare & Medicaid Services (CMS) has certified the nonprofit California Healthcare Performance Information System (CHPI) to participate in its Medicare Data Sharing for Performance Measurement Program. The Affordable Care Act allows “qualified entities” to combine Medicare and health plan insurance claims data to provide health care performance information. The new CHPI multi-payer claims database will pool claims and other data from California health plans and CMS to produce physician, medical group and hospital performance ratings using quality, efficiency and appropriateness measures. CHPI is managed by the Pacific Business Group on Health (PBGH), a consortium of CalPERS, Covered California, health plans, large businesses and public employers. CHPI is funded through a grant from Blue Shield of California, PBGH purchasers’ contributions and support from participating health plans. Legislation enacted last year, SB 1196, prohibits contractual provisions that restrict the disclosure of health care claims data to a CMS-qualified entity.