Create one SUPER database to house all Medicare and Medicaid claims data
Because claims data is widely dispersed with no central repository, this allows for fraud,waste and abuse to happen without a central intelligence overseeing trends and patterns in both Medicare and Medicaid data (including managed care data!). In the spirit of uniformity and Health Reform-we must move towards a centralized data warehouse where we can keep our eyes on the claims and utilization.
OIS responded that this idea is in current development. The vision of the Integrated Data Repository (IDR) is exactly that of a super claims database that will house ALL Medicare and Medicaid claims (encounters) data. To date, the IDR project has successfully populated Medicare claims and supporting Beneficiary data. Medicaid and Encounter claims data proposed in your suggestion will be populated in the near future, pending funds.
OIS agrees that CMS will greatly benefit from a database that contains all of the claims data submitted. As there have been several calls for a national level database not only for fraud, waste, and abuse purposes, but also for researchers, policy makers, actuaries, etc. The simplicity of the concept is that a user would have access to all the data required in a single location without the complications of complex middleware. The technology supporting IDR is capable of completing this vision.