Portfolio

Milliman Launches Research Tool Built On CMS Qualified Entity Data

Interactive dashboard measures healthcare system performance and displays SDoH characteristics

December 07, 2023 01:27 PM Eastern Standard Time–SEATTLE–(BUSINESS WIRE)–Milliman, Inc., a premier global consulting and actuarial firm, today announced the availability of a new interactive research dashboard that shows healthcare provider performance metrics and social determinants of health (SDoH) characteristics. The Milliman Qualified Entity Reporting Dashboard provides newfound visibility into healthcare provider performance metrics and SDoH characteristics. The dashboard allows payers, providers, and researchers to drill down by geography to the ZIP code tabulation area (ZCTA) level of granularity. The Milliman Qualified Entity Reporting Dashboard is available for public use at http://www.milliman.com/qualifiedentity.

The tool was developed by Milliman to support its participation in the Centers for Medicare and Medicaid Services (CMS) Qualified Entity Program. Under the QE Program, also known as the Medicare Data Sharing for Performance Measurement Program, organizations receive Medicare Part A, B, and D claims data, which they can use to analyze provider performance and for other research purposes. Participating organizations are also required to use the data to produce publicly available CMS-approved reports on provider performance. Milliman took the opportunity to go beyond the requirement to produce a report and instead developed an interactive tool and dashboard for use by external users.

“Our membership in the Qualified Entity Program has given Milliman the opportunity to bring new insights to the market. With the largest potential pool of Medicare data available as the foundation, we have dedicated Milliman’s unparalleled expertise with claims data toward developing a provider performance dashboard unlike anything else currently available,” says Pamela Pelizzari, Milliman principal and healthcare consultant.

The dashboard can help answer complex questions for payers, providers, and researchers such as:

  • How does healthcare provider performance vary between regions?
  • How do a given region’s SDoH characteristics differ from those of another region?
  • How do different regions vary in important metrics like risk-adjusted acute hospital utilization and readmission rates?
  • How are acute hospital utilization and readmission rates associated with different SDoH characteristics?
  • What are the key healthcare provider performance considerations for payers expanding into a new market?

Milliman is one of 38 approved QEs and has been certified since 2020. For more on the QE program, go to https://www.cms.gov/data-research/monitoring-programs/qualified-entity-program. To access The Milliman Qualified Entity Reporting Dashboard, go to http://www.milliman.com/qualifiedentity.

 

 

 

About Milliman
Milliman is among the world’s largest providers of actuarial, risk management, and technology solutions. Our consulting and advanced analytics capabilities encompass healthcare, property & casualty insurance, life insurance and financial services, and employee benefits. Founded in 1947, Milliman is an independent firm with offices in major cities around the globe. Visit us at milliman.com.