5 Reasons to Like CMS's "Data Marketplace" Initiative
Dear Healthspottrs, If you’re like me, by now you gloss over the frequent missives from HHS and CMS. It's not that I don’t care, it’s just that keepingup with all the announcements, modifications and new initiatives is a fulltime job. It means overtime if I really want to understand them. So it is with rare enthusiasm that I ask you to support a new idea that CMS will be quietly floating to industry innovators in the coming weeks. If CMS garners enough support from communities like ours, this initiative could present a huge opportunity for healthcare entrepreneurs, particularly those who work in data analytics.
Put succinctly, the initiative seeks to establish a comprehensive and open marketplace for healthcare data, starting with CMS data. Like a lot of federal programs, this one is poorly marketed: CMS is calling it the Knowledge Discovery Infrastructure (KDI), an unfortunately lofty name that only vaguely indicates its mission. The companion slide deck I reviewed is 25 slides too long and only confuses CMS’s message. (All you need is slide 16, shown below.)missives from HHS and CMS. It's not that I don’t care, it’s just that keepingup with all the announcements, modifications and new initiatives is a fulltime job. It means overtime if I really want to understand them. So it is with rare enthusiasm that I ask you to support a new idea that CMS will be quietly floating to industry innovators in the coming weeks. If CMS garners enough support from communities like ours, this initiative could present a huge opportunity for healthcare entrepreneurs, particularly those who work in data analytics.
But Healthspottr recently took a call with CMS’s Vish Sankaran, a chief architect behind KDI and a special advisor to Acting Administrator Marilyn Tavenner. Turns out Sankaran is a patient man with a mind for the private market. So, after some translating, we’ve broken down the significance of KDI into a few bullet points.
5 Reasons To Support KDI:
- KDI reforms the way CMS contracts with its data analytics vendors. Traditionally, when CMS needs a set of its data analyzed (e.g. to discover claims fraud), it puts the task “to bid” through a system that serves a small universe of analytics companies with longstanding relationships to CMS. KDI replaces this closed, legacy system with an open system that invites hundreds or even thousands of additional and new analytics vendors to bid on such projects.KDI reforms the way CMS contracts with its data analytics vendors.
- KDI also establishes a Web-based marketplace, or platform, where all vendors may openly bid on CMS data projects, infusing the process with competition on everything from the project term to price.
- KDI requires CMS to restructure its data stores. Today CMS data are structured by a multitude of standards and formats. (Read: there are no standards.) But for a Web-based marketplace to be of any use, it is not enough for vendors to have access to the CMS data; they must also be able to understand and code for the data. Right now “fewer than 100 people know how to access and use CMS data,” Sankaran told Healthspottr, and they are the very same privileged vendors who’ve been participating in CMS’s legacy contracting system as noted above. (We might call them Beltway Bandits.) To support the new open marketplace, KDI requires CMS to restructure its data into a smaller subset of established standards, and then organize it in such a way that any new vendor can easily use the data. (Think of this step as reducing the number of languages in a marketplace from 1,000 to 10.)
- KDI encourages the private market to restructure its data stores. Private sector provider systems and payers will need to restructure their own data if they, too, want to use the CMS marketplace for data analytics—and if it exists, they’re going to want to use it. This is how KDI can help organize the market for data analytics. (This is a similar concept to establishing standards, the more common tactic of government. But merely organizing the market is faster and more efficient, because it leaves open the opportunity for new and better standards to evolve over time.)
- KDI establishes a framework for value-based purchasing. Once CMS builds a marketplace where data analytics shops openly compete for jobs, customers will begin discriminating on price and quality. This will be new to providers and payers, and especially novel for CMS program administrators. But it also will be habit-forming. Soon enough, all parties will start using data analytics contractors to help them discern which “vendors” in myriad other healthcare service categories (e.g., laboratory testing; ambulatory clinics; in-home care) are delivering high quality work at a reasonable cost.
Despite the muddled pitch, KDI's potential ROI is clear: To CMS, it is the glue that makes bundled payments, ACOs and patient-centered medical homes possible. At a minimum for Healthspottr members—including the care providers whose work ultimately will be measured, as well as the creators, funders and purchasers of data analytics tools—KDI offers a potentially powerful distribution channel to startups in the analytics space. At the maximum, KDI can accelerate the industry’s migration toward value-based purchasing. Either way, supporting KDI is a win-win for Healthspottrs.
If only CMS would rename the darned thing with something more straightforward and catchy, like ... The CMS Data Marketplace perhaps?
Here is a slide that tells the KDI story well: