It wasn't exactly John Adams and the midnight judges, but Mark McClellan did pack a lot into last Friday, his final work day as CMS Administrator. Much of the attention will likely go to a new report that touts the costs savings CMS says the Part D drug benefit is bringing to Medicare and the treasury. But there was another initiative announced Friday -- ostensibly about Part D, too -- that confirms a deeper trend coursing through Medicare.
This second announced action concerns a proposed regulation to be published Tuesday on use of Part D data. Patterned along the general lines of Grassley-Baucus legislation, the reg is intended to help identify potential drug side effects and get a better read on disease management. But the reg will also propose broader linkages between Part D information and that derived from Parts A, B, and C. Thus, while on the the whole seeming a bit narrow and researchy, the reg is actually part of a larger revolution -- one that seeks not only to draw on jumbo data banks to produce an integrated understanding of benefits (see previous post, "Part B v. Part D Drug Coverage: Bombs Away"), but also to snap a holistic picture of beneficiary service utilization. Indeed, if the Internet is today's information superhighway, then Medicare may be tomorrow's nuanced data tapestry.
We wrote over a year ago ("The Coming Data Convergence") that "big, robust patient data bases are emerging as a broad new analytical commons where CMS and FDA will convene to decide Medicare coverage and product safety issues." In this new world, "the volume of post-market data can trump the randomization of clinical trials in getting to the bottom of a product's performance and outcomes" ("Gottlieb Move May Punch Up CMS-FDA Post-Market Collaboration").
Medicare claims information, which has evolved from drab administrative utility to analytic rock star, serves as the conducting material for much of this new data mining and benefits crosshatching. Such has come about in no small part because of new electronic systems that can aggregate isolated health care events and turn them into an insightful and powerful plural.
So read Tuesday's reg not only for what it says . . . but for what it may signal.
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