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The center will study variances not


only by geographical region, but also among different payer systems, such as Medicare, Medicaid, and commer- cial insurance. Although CMS allows qualified entities to sell Medicare claims data to practitioners, health plans, and others, Dr. Ganduglia-Ca- zaban says the center won’t “go into the business of selling the data.” But it will use the data for other research projects and will partner with other organizations.


Although measuring practitioner performance is a stated goal of the CME Qualified Entity Program, the center’s work won’t be “calling out” specific physicians for high or low performance. “We’re not reporting on any par- ticular providers at this point in time, aRSMR K VY^ YP [_KVS ON OX^S^SO] NY% ^ROc actually name the providers. We’re not doing that,” Dr. Krause said. “We’re looking more at variation across the state, and where [there are] areas that potentially need improvement, so we can really focus policy on those areas.” Dr. Ehrlich cautions that the Medi-


care data has limitations. “We don’t want to overstate it, be- cause there may be a very small county that only has 500 patients in it, and [the quality measures can look] hor- rible because of one outlying utilizer. But because the mean is more influ- enced by more populated areas, the way that the statistics are done, they may be at an advantage or a disadvan- tage,” she said. “For instance, all they have to have is one really sick patient who overutilizes in a small group to make that county look like an outlier.” Still, she calls the project “exciting


and new.”


“They can go as granular as by ZIP code or as large as by region, and it is really exciting information to see,” she said. “They can definitely show disparities.” Q


Joey Berlin is associate editor for Texas Medicine. You can reach him by phone at (800) 880-1300, ext. 1393, or (512) 370-1393; by fax at (512) 370- 1629; or by email at joey.berlin@texmed.org.


November 2017 TEXAS MEDICINE 53


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