Policies and Activities to Promote Availability of Data Resources
Increased capabilities for supporting transparency of data to the public are emerging from new policies and activities. These include statutory and regulatory authorities that are in place now to create pathways for new data products and services. Additional steps are being taken through administrative and management policies that are guiding programs and agencies to greater transparency.
Prevention and Public Health Fund Reporting
Public reporting requirements on funding of prevention and public health fund projects will be a new resource in 2012. Section 220 of the Consolidated Appropriations Act, FY 2012, Public Law 112-74 requires HHS to establish a publicly-accessible website to provide information regarding the uses of prevention and public health funds made available under section 4002 of the Patient Protection and Affordable Care Act (Public Law 111-148) including:
- A statement indicating the program or activity receiving funds, the Operating Division or office that will administer the funds, the planned uses of the funds, to be posted not later than the day after the transfer is made.
- Identification (along with a link to the full text) of each funding opportunity announcement, request for proposals for grants, cooperative agreements, or contracts intended to be awarded using such funds, to be posted not later than the day after the announcement or solicitation is issued.
- Identification of each grant, cooperative agreement, or contract with a value of \o5,000 or more awarded using such funds, including the purpose of the award and the identity of the recipient, to be posted not later than five days after the award is made.
- A report detailing the uses of all funds transferred under section 4002(c) during the fiscal year, to be posted not later than 90 days after the end of the fiscal year.
- Semi-annual reports from each entity awarded a grant, cooperative agreement, or contract from such funds with a value of \o5,000 or more, summarizing the activities undertaken and identifying any sub-grants or sub-contracts awarded (including the purpose of the award and the identity of the recipient), to be posted not later than 30 days after the end of each 6-month period.
This resource will be developed starting in March 2012 with semi-annual reports to follow once the reporting methods are established.
Health System Tracking Project
The Health System Tracking Project brings together trend data on a limited set of key health system measures from multiple data sources to provide a picture of the status of the U.S. health system. The Project focuses on ten critical dimensions of our health care system. These dimensions encompass the availability of care, the quality of care, the cost of care, the health of the population, and the dynamism of our health care system. The Project examines the evolution of these aspects of our system over time. It also assesses the status of these dimensions of the system with respect to subgroups of the population, with a particular emphasis on vulnerable populations.
HHS has developed the Health System Tracking Project to ensure a robust monitoring system through which people inside and outside government can assess how the system is doing and identify areas that need improvement. One important purpose of the Project is to track the consequences of implementation of The Affordable Care Act, signed into law in March 2010 across this broad set of dimensions of the health system. Each measure will include an explanation and applicable metadata, which will be displayed along with links to additional information about the data sources. Data will be updated annually on an ongoing basis. The system will include site-wide analytics so that administrators can track civic engagement with the data. These analytics will include trend data on measure visitation and allow us to identify the most visited datasets and track site-wide search trends. A public launch of the tool is anticipated in summer 2012.
Food Safety Modernization Act – High Risk and Non-Risk Inspections
The Food Safety Modernization Act (FSMA), enacted on January 4, 2011, established a mandated inspection frequency for food facilities that must register under the Bioterrorism Act that is based in part on the inherent risk of facilities. All “high-risk” domestic facilities must be inspected within five years of FSMA enactment and no less than every three years thereafter. All “non high-risk” domestic facilities must be inspected within seven years of enactment and no less than five years thereafter. FDA will make publicly available the criteria that will be used in defining “high risk” and “non high risk” domestic food facilities. In addition, at the end of each fiscal year, the Agency will make available the number of high risk and non high risk inspections for each state.
CMS Data and Information Product Strategy
The core business at CMS is evolving from a fee-for-service-based payment system to that of a value-based purchaser of care. Additionally, CMS responsibilities are expanding to incorporate stewardship of Affordable Insurance Exchanges under the Affordable Care Act and the collection of clinical data under the HITECH program. With full implementation of the Affordable Care Act, CMS will play a direct or indirect role in administering health insurance coverage for more than 100 million people across the Medicare, Medicaid, CHIP, and Exchange populations. This will result in data generation and creation on a massive scale, even for an agency that currently processes 1.5 billion Medicare claims per year while collecting over ½ terabyte of data each month from various activities. Further, the type of data that CMS collects is expanding from the traditional administrative elements needed for provider payment purposes to include a richer set of clinical elements and to a broader covered population. The current approach to data release at CMS is guided by the application of multiple statutory authorities, systems that are not optimized for the rapid or cost effective release of data and processes that often frustrate existing data users. CMS data and information products will be a key component in this evolution to a value-based purchaser, and, as such, should become a core business function for CMS. Without timely, relevant data CMS will not be able to define or reward value. Without access to CMS data, the health care system will not successfully transform into one that maximizes health and value. In the future, a properly functioning data and information enterprise will be critical to CMS operations for the Medicare, Medicaid, CHIP and Exchange programs. Indeed the ongoing evolution of these programs will depend on CMS’s ability to harness its data and information products. CMS will, in partnership with others, help advance better care, better health and lower costs in the United States through excellence in operations in data collection, analysis and dissemination, enabling ease of access and use for internal and external users. CMS will ensure that data dissemination practices are consistent with beneficiary wishes,concerns and laws that protect beneficiary privacy. CMS will efficiently capture and structure administrative and clinical data and make it available in a wide range of formats to the maximum number of users in a timely fashion. This will promote ongoing transparency and innovation in the development of tools and analyses to improve health and health care, as well as protect CMS programs the trust fund from acts of fraud, waste, and abuse. The work schedule is as follows: mission statements and principles will begin in January 2012, public rollout will begin in February/March 2012, and the plan will be put into operation in March through December 2012.
Medicare Data Sharing for Performance Measurement
The Medicare Data Sharing Program for Performance Measurement provides standardized extracts of Medicare claims data to qualified entities to enable them to measure the performance of providers and suppliers in ways that protect patient privacy. Under the Medicare Data Sharing Program, CMS makes standardized extracts of Medicare Parts A, B, and Part D claims data available to qualified entities for the evaluation of performance of providers. Qualified entities must combine the Medicare claims data with claims data from other sources to generate reports and must publicly report measure results. However, public reports generated by qualified entities may only include information on individual providers and suppliers in aggregate form to protect beneficiary privacy and may not be released to the public until the providers have had an opportunity to review them and ask the qualified entity for corrections. The program has strict privacy and security requirements to protect patients and health care providers as well as misuse of Medicare data may lead to the qualified entity being removed from the program. This program creates a framework for improvements in the quality of care. Major milestones for the program include the release Medicare claims data to qualified entities starting in March 2012 and generating the first public reports generated using combined Medicare claims data and claims data from other sources.
CMS Financial Alignment Initiative
In FY 2011, the Medicare-Medicaid Coordination Office, in partnership with the Innovation Center, established a demonstration opportunity for states to align the service delivery and financing between Medicare and Medicaid through the Financial Alignment Initiative. Many states will submit proposals to CMS to participate in this demonstration. In continuing efforts for meaningful stakeholder input, CMS is requiring states to post their proposals for 30 days before officially submitting the proposal to CMS. Once CMS receives each state’s proposal, CMS will post it online for 30 days for comment to allow for another round of public comment. Publicly posting the proposals facilitates an open and transparent process and supports the Administration’s directive on open government.
Annual Release of Survey Paradata
Paradata are the detailed information on the mechanism of how a survey is carried out from the timing of interviews to interview locations to in some cases individual keystrokes on the interviewer’s computer. The data provides a wealth of measures on the quality of survey administration and therefore on the quality of a survey’s product: its data. The National Center for Health Statistics is conducting this project which represents a major advance in providing public and private survey researchers insight into how the principal health data survey of the Federal Government is conducted. It provides a window – a transparent interface – into the survey that will be invaluable to survey researchers and health policy analysts alike. Access to paradata allows National Health Information Survey data users to conduct methodological studies, such as relating response rate to number of attempts or relating item non-response rates to initial response to interview attempts.
Tobacco Regulation, Education, and Prevention Information – Content Syndication Pilot
FDA Center for Tobacco Products will launch an effort to make the Family Smoking Prevention and Tobacco Control Act (Tobacco Control Act) easier to access, search, and navigate on the web. The development of this more accessible search functionality was tested with stakeholders for ease-of-use and developed in collaboration with plain language experts. The undertaking aligns with the Administration, HHS, and FDA initiative to increase transparency and the recent Plain Language Act. The accessible Tobacco Control Act project provides:
- A searchable version of the law. When launched, the search feature will enable the public to search the act by “Audience,” “Type of Tobacco,” and “Topic” to find relevant sections of the act. A detailed spreadsheet was created to organize the law to improve search accuracy. Each search results page provides a link to the full statute for complete information.
- A more navigable act. The searchable Tobacco Control Act breaks down the 84 pages of legal language in the law and provides the exact information in a more usable structure with navigation to help the public find information faster.
- An overview of the law, including an appropriate disclaimer that links to the full Act for more information.
- A scrolling timeline of key deliverables of the act, and an infographic timeline including key deliverables, images, and the act’s public health rationale.
The next phase will be to map links between the law and FDA actions (e.g., regulations, guidance documents, etc.). Work is ongoing and expected to be online in Spring 2012.