During her remarks at the 2018 Health Datapalooza, CMS Administrator Seema Verma stated that the advancement of value-based care requires a patient-centered health care system, where patients are empowered healthcare consumers making informed decisions.  The cornerstone of such a system is data: quality data; cost data; and a patient’s own data.

To address these challenges, Administrator Verma announced CMS’ new “Data Driven Patient Care” strategy, based on the following three cornerstones: (1) Putting patients first; (2) Increasing the amount of available data; and (3) Taking an Application Programming Interface (API)-first approach for sharing data.

CMS has already pulled several levers available to implement its vision -- from liberating data to motivational policies.  For example, during Health Datapalooza, the Administrator announced that CMS will be releasing Medicare Advantage data to researchers this year, and is targeting the availability of Medicaid data to patients next year. Additionally, in late April, CMS released several proposed rules that advance the patient-centered healthcare system vision, reduce and focus quality measures, and re-align and re-brand the EHR Incentive/Meaningful Use program to “Improving Interoperability.”

Looking ahead, there are key areas that CMS and the health industry at large can consider for strategic emphasis that could have high impact on improving care by expanding patient access to data and ensuring clinicians have access to all the data needed for care coordination. These include: 

  1. Developing measures that matter to patients. Now that CMS has proposed removal of non-value-add measures, CMS can work together with patient advocates, clinicians and health system organizations to fill critical measure gaps that make a difference for patients. Handling of patient-reported outcomes, for example, is one gap where assessment and collaborative change could have high impact.  
  2. Making patient engagement the rule. Looking across the entire rulemaking process, we can immediately accelerate interoperability and make patient engagement the rule, not the exception, in every policy. This initiative includes assessing the patient impact of inter-related policies across multiple CMS programs from early policy analysis through rule drafting, and impact analysis.
  3. Promoting open APIs and patient engagement in alternative payment models (APMs). CMS has multiple ongoing initiatives focused on accelerating alternative payment models to improve care and reduce cost. The Agency and the broader healthcare community can consider applying their efforts across these payment model initiatives to support and incentivize interoperability and open APIs that enable patient engagement and allow patients to access their data. 
  4. Evolving industry-wide data management approaches to enable patient data sharing and engagement. From a broader industry standpoint, health system stakeholders can also implement recommendations proposed in an October 17, 2017 article in the Journal of the American Medical Association. Co-authored by the Scripps Translational Science Institute and MITRE, the article recommended creation of “(1) common data elements that enable sharing and merging of health data from multiple sources; (2) a patient encounter data receipt…automatically pushed to a patient’s digital health record; and (3) a contract between patients and third-party health data managers…that enables individuals to control their longitudinal digital health record.”

CMS’ actions are a step in the right direction to advance data-driven value-based care through a patient-centered health system. These efforts, combined with complementary efforts outlined above, can speed our nation’s health system to become truly patient-centered.


The author's affiliation with The MITRE Corporation is provided for identification purposes only, and is not intended to convey or imply MITRE's concurrence with, or support for, the positions, opinions or viewpoints expressed by the author.

The opinions expressed in this blog post are the author's own and do not necessarily reflect the view of AcademyHealth.

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Kimberly Warren

Kimberly Warren

Portfolio Director - MITRE

Kimberly Warren is Portfolio Director for the CAMH FFRDC, which works to advance the nation’s progress toward ... Read Bio

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