Our View: NRHI welcomes expansion of the Qualified Entity program to further spread transparency

The  Network for Regional Improvement (NRHI) welcomes Amino as the 13th Qualified Entity (QE) recognized today by the Centers for Medicare & Medicaid Services (CMS). NRHI members make up 10 of the 11 QEs certified by CMS to report regionally and were among the first organizations in the country to earn the designation.

NRHI President and CEO Elizabeth Mitchell explains, “Those first regional QEs believed Medicare data could be a powerful ingredient in their work to improve the quality and value of healthcare in their communities. They have been incredibly effective at helping providers understand and use this data for quality improvement.”

NRHI expects Amino’s strong ability to provide transparent information to consumers will be an important complement to the effective work performed by regional QEs to help providers use data to improve care.  Regional QEs also provides purchasers with a complete picture of what payer performance reporting offers so they can move their healthcare dollars to higher-value providers.

In August 2014, NRHI member Oregon Health Care Quality Corporation (Q Corp) was the first QE to publicly report on provider performance using Medicare, private payer, and Medicaid data.  Including Medicare data has allowed Q-Corp to offer providers and consumers more complete information about the quality of care in Oregon. The Medicare data also allowed Q Corp to publish quality measures for clinics that did not have a large enough patient population to permit reporting using only commercial and Medicaid claims.

Today, Oregon physicians are actively using those results to guide their quality improvement efforts. NRHI expects rule-making to implement the broader uses of data from QE programs described in the Medicare Access and CHIP Reauthorization Act (MACRA) will enhance the ability of regional QEs like Q Corp to generate higher value care in their communities.

NRHI and its members across the country produce and report on the quality, utilization, and patient experience of health care region-by-region and are increasingly collaborating to produce nationally-consistent reporting. They look forward to exploring the opportunity to partner with Amino to increase transparency for all stakeholders.