The Centers for Medicare and Medicaid Services (CMS) announced on September 19 that it will be making its Accountable Care Organization (ACO) Database System available after October 19 to support implementation of the Medicare shared savings program and the Pioneer Accountable Care Organization (ACO) model. Those programs will involve groups of providers that agree to work together under innovative business models to manage and coordinate care for Medicare fee-for-service beneficiaries. The groups will qualify to receive from Medicare a share of the savings that they achieve if they create a legal entity authorized to receive and disburse those incentive payments within the group and they meet ACO quality of care and performance standards.  Savings will be calculated using benchmarks derived from Medicare Part A and Part B utilization and expenditure data. The ACO Database System includes confidential information but will be made available by CMS to authorized contractors, grantees, and consultants on a need-to-know basis.  Section 3022 of the Affordable Care Act (ACA) requires CMS to implement the ACO program by January 1, 2012.

The Health Care Cost Institute (HCCI), a distinguished private non-profit organization, similarly announced on September 20 that it will allow researchers and policy makers access to “de-identified” information (HIPAA-compliant claims data without any information that might be used to identify specific individuals) from Aetna, Humana, Kaiser Permanente, UnitedHealthcare, Medicare fee-for-service, and Medicare Advantage plans. HCCI is led by Carnegie Mellon University Professor Martin Gaynor and a board of directors that includes many other pre-eminent health economists such as MIT Professor Jonathan Gruber.  HCCI seeks to stimulate objective analysis on the underlying causes of rising health costs in the United States and to encourage development of innovative business models to achieve greater value from health care spending. HCCI’s multi-payer, multi-year database contains over 5 billion records representing over a trillion dollars in health spending.