AMGA Calls for Access to Claims Data in Comments on CMS, ONC Proposals
Sees Potential for Improved Data Sharing

Alexandria, VA – In comments filed today on two interoperability proposed rules, AMGA stressed the need for access to claims data, which is a vital part of care delivery in a value-based model and should be the basis for any reforms to interoperability standards and requirements.

AMGA recommended in its comments that the Centers for Medicare & Medicaid Services (CMS) and the Office of the National Coordinator (ONC) use application program interfaces to share claims data to ensure providers have full access to a patient’s medical history. Access to claims data from all payers has been a longstanding priority for AMGA and its members. A major impediment to the move to value is that pieces of information are kept in various unconnected systems that do not follow the patient through every encounter within the healthcare system.

“Sometimes we forget that the power of information technology is as a tool providers can use to better treat patients,” said Jerry Penso, M.D., M.B.A., AMGA president and chief executive officer. “Standards and interoperability are important and should not be overlooked, but we can’t lose sight of the why we use such systems. And that’s to ensure our care teams have all the information necessary to provide patients the best care and practices have the data needed to develop population health strategies. That’s the promise of interoperability, but we know these systems are only as strong as the data they transmit, which is why we need real-time claims data.”

AMGA’s comments on the CMS and ONC rule are based on the need for information sharing and tracking a patient’s health care journey. This includes requiring hospitals to send electronic notifications in the event of patients’ admission, discharge, and/or transfer to another healthcare facility or to a community provider. It also requires improvements to patient matching standards, so that data elements are standardized. When AMGA’s members are confident they have a full understanding of the patient they not only can provide optimized treatment, they can analyze data across their patient population to develop population health strategies to address chronic disease.

The full comment letter to CMS is available here, and the letter to ONC is available here.


About AMGA
AMGA is a trade association leading the transformation of health care in America. Representing multispecialty medical groups and integrated systems of care, we advocate, educate, innovate, and empower our members to deliver the next level of high performance health. AMGA is the national voice promoting awareness of our members’ recognized excellence in the delivery of coordinated, high quality, high-value care. More than 175,000 physicians practice in our member organizations, delivering care to one in three Americans.


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