Californians now have a new, trustworthy source of information to help them make smart healthcare buying decisions. The California Healthcare Performance Information System (CHPI) will become the State’s largest source of healthcare performance information for consumers and purchasers, generating performance ratings of physicians, medical practices and hospitals.
CHPI is a multi-payer claims database that puts the public and purchasers first, helping Californians better understand the underpinnings of high-quality care and providing information for: choosing doctors or hospitals, knowing what care works and what doesn’t, and avoiding wasteful and harmful healthcare services.
In early February, the federal government designated CHPI as a “Qualified Entity” – as such, the Centers for Medicare and Medicaid Services (CMS) will release the California Medicare data for CHPI to use in its performance accountability services. By combining the Medicare data with health plan insurance claims, CHPI will use the healthcare experiences of millions of people to identify those healthcare professionals who provide high quality care.
“By shining a light on the performance of healthcare providers, CHPI will help individuals and businesses choose the hospitals, medical practices and doctors providing the best value,” said CHPI Board President Tom McCaffery. “It also will support healthcare providers’ efforts to improve the quality and efficiency of patient care.”
CHPI is funded through a grant from Blue Shield of California, PBGH purchasers’ contributions, and support from participating health plans. The Pacific Business Group on Health will manage day-to-day operations through a management services agreement.
Qualified Entity Status
CHPI is one of the first organizations in the U.S. to be designated as a Medicare Qualified Entity. The Medicare Data Sharing for Performance Measurement Program was made possible by the Patient Protection and Affordable Care Act. The program makes Medicare claims data available, under strict privacy requirements, to groups that the federal Department of Health and Human Services (HHS) certifies as qualified to handle this data and protect patient privacy. HHS requires that this Medicare data be combined with commercial or other data to produce public reports on the performance of physicians, hospitals or other healthcare providers.
How CHPI Uses Performance Information
CHPI works with all those who have a stake in quality, affordable care including purchasers, health plans, consumers, government agencies and providers. CHPI will use Medicare and commercial insurance data to:
Furthermore, CHPI benefits from a recently enacted California law, SB1196, which prevents healthcare providers from contractually prohibiting health plans from reporting medical claims data to a Medicare Qualified Entity in California. This legislation ensures that CHPI can provide all Californians with more complete and meaningful information about the quality and efficiency of patient care.
CHPI Names Board of Directors
A board of directors comprised of representatives from health plans, purchasers, hospitals, consumers, and physician groups oversee CHPI. Board members are: Steve Barron, Dignity Health; Ann Boynton, CalPERS; David Lansky, Pacific Business Group on Health; Jeffery Mason, MD, UnitedHealthcare; Tom McCaffery, Blue Shield of California; Steven Scott, Anthem Blue Cross; John Stenerson, Self-Insured Schools of California; Barton Wald, MD, Providence Health & Services; and Elizabeth Helms, California Chronic Care Coalition.