Creating De-Identified Claims Data

Creating De-Identified Claims Data

The Centers for Medicare & Medicaid Services (CMS) want to develop statistically de-identified Medicare claims data to meet the growing demand for access to Medicare data.

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Medicare claims data are collected and assembled by the Centers for Medicare & Medicaid Services (CMS) as a byproduct of Medicare program administration. These data provide an unparalleled source of information on the costs and quality of health care in the United States. Each year hundreds of researchers, providers, and contractors request and receive sensitive Medicare data as part of their research studies and health care operations activities. However, regulations and policies have limited access to identifiable data (data that connects to the beneficiary’s identity) to protect beneficiary privacy. Data releases for program evaluations, demonstrations, and research projects have been supported, whereas releases for analytic and public reporting purposes have been more limited and use for commercial purposes has been prohibited.

To support the use of Medicare claims data by a variety of users in a manner that protect beneficiary privacy, CMS is interested in adding statistically de-identified Medicare claims data to its product portfolio. Statistically de-identified data would include actual beneficiaries with their associated diagnoses, treatments, outcomes, and costs. This beneficiary experience represents the real world of health care in the Medicare program and although the removal of identifiers and geography may limit some research objectives, de-identified data can still provide a rich resource to support a wide range of desirable health care system analytics. For example, these data could provide information for commercial and nonprofit companies for the evaluation of treatments and drugs, examination of trends in health care cost and service utilization, and development of new analytic methods and tools.

CMS is looking for an entrepreneur with a background in statistics and mathematics. Below are a list of specific skills and qualifications desired:

  • Statistics/Mathematics: data expert with knowledge and experience in data de-identification.
  • Experience with health, health care, and/or insurance data
  • Knowledge of Medicare and the Health Insurance Portability and Accountability Act (HIPAA) beneficial but not required.
  • Ability to teach others methodologies for statistical de-identification.
  • Past project management experience, especially in design, implementing and measuring the success of pilots
  • Ability to engage with various stakeholder communities and create meaningful change

As an entrepreneur you have the chance to make a meaningful difference in lives of millions of Americans. Creating statistically de-identified data is no easy feat, but the outcome of doing so can lead to many opportunities down the road. You will have the chance to network with individuals across government as well as the private sector.

If this opportunity sounds like a perfect fit you, apply now or share the opportunity with  someone.  Applications will be open from May 5, 2014 – July 16, 2014.

Niall Brennan, Centers for Medicare & Medicaid Services
Andy Shatto, Centers for Medicare & Medicaid Services
Chris Cox, Centers for Medicare & Medicaid Services
Allison Oelschlaeger, Centers for Medicare & Medicaid Services
Kari Gaare, Centers for Medicare & Medicaid Services

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