This month, startup analytics company Amino became the first for-profit company to gain access to the Centers for Medicare and Medicaid Services‘ vast database of Medicare claims. San Francisco-based Amino also is just the second organization of any kind — the other being the not-for-profit Health Care Cost Institute — to be named a CMS “qualified entity” to report on nationwide Medicare claims data; others are restricted to specific counties or states.
CMS this year reversed a longstanding policy that private-sector researchers could not mine CMS data for commercial purposes. The agency started taking requests for access in September.
The approval, given Dec. 4, but not widely announced until this week, means Amino will be able to augment its physician search tool with claims from the nation’s largest payer. “With the addition of Medicare data, Amino will enhance its free service to help Americans make care decisions, including, for example, determining the providers from whom they choose to receive services,” CMS Chief Data Officer Niall Brennan wrote in a blog post.
According to Amino CEO and Co-founder David Vivero, CMS has collected about 3 billion Medicare claims a year since 2009. “Our goal is to make this information available to everyone,” Vivero said.
The startup, which launched in October, seeks to provide consumers with physician searches based on individual conditions, service needs, health insurance coverage and personal preferences. To get the most accurate picture, “It’s necessary to combine commercial [insurance] data with Medicare data,” Vivero said.
Amino already has information on 5 billion healthcare interactions, involving about 188 million people. Medicare covers at least 52 million Americans, though more than 14 million of those are on privately administered Medicare Advantage plans, so they may already be in Amino’s database.
The Medicare claims data Amino is gaining access to includes records from the Part D prescription-drug program. “We can see physician prescribing patterns” with this information, Vivero noted.
A Deep-dive Into Specialty Pharma
A specialty drug is a class of prescription medications used to treat complex, chronic or rare medical conditions. Although this classification was originally intended to define the treatment of rare, also termed “orphan” diseases, affecting fewer than 200,000 people in the US, more recently, specialty drugs have emerged as the cornerstone of treatment for chronic and complex diseases such as cancer, autoimmune conditions, diabetes, hepatitis C, and HIV/AIDS.
Vivero said he expects to be able to download the Medicare data store starting in the first quarter of 2016., and then Amino will get to work on analyzing that information.
Photos: Amino, Flickr user r2hox
