Qualified Entity Program
The CMS Qualified Entity (QE) Program (also known as the Medicare Data Sharing for Performance Measurement Program) enables organizations to receive Medicare claims data under Parts A, B, and D for use in evaluating provider performance. Organizations approved as QEs are required to use the Medicare data to produce and publicly disseminate CMS-approved reports on provider performance. QEs are also permitted to create non-public analyses and provide or sell such analyses to authorized users. In addition, QEs may provide or sell combined data, or provide Medicare claims data alone at no cost, to certain authorized users. Under the Qualified Entity Certification Program (QECP), CMS certifies QEs to receive these data and monitors certified QEs.
Certified Qualified Entities (November 10, 2020)
|
Name of Lead Entity |
Region(s) in which QE will publicly report provider performance |
Date of QE Certification |
| Milliman, Inc. | 46 entire states | August 21, 2020 |
| Abacus Insights | New Jersey, Idaho, Washington, Oregon, Utah | July 14, 2020 |
| McKinsey & Company | All 50 States and the District of Columbia | October 10, 2018 |
| Wisconsin Hospital Association Information Center | Wisconsin | October 15, 2019 |
| Humana Healthcare Research, Inc | Kentucky and select counties in 8 states | October 1, 2019 |
| The Health Collaborative | 7 counties in Ohio | August 31, 2012 |
| Wisconsin Health Information Organization | Wisconsin | August 5, 2013 |
| Center for Improving Value in Health Care | Colorado | August 5, 2013 |
| Minnesota Department of Health, Division of Health Policy | Minnesota | August 5, 2013 |
| Midwest Health Initiative | St. Louis MSA and 16 counties in Central Missouri | September 17, 2013 |
| Health Care Cost Institute | All 50 states and the District of Columbia | June 17, 2014 |
| Amino | All 50 states and the District of Columbia | December 4, 2014 |
| OptumLabs | All 50 states and the District of Columbia | November 30, 2015 |
| FAIR Health | All 50 states and the District of Columbia | May 18, 2016 |
| Virginia Health Information | Virginia | June 7, 2016 |
| Greater Detroit Area Health Council | 7 counties in Southeastern Michigan | October 24, 2016 |
| Inovalon | All 50 states and the District of Columbia | March 17, 2017 |
| OM1, Inc | All 50 states and the District of Columbia | March 17, 2017 |
| University of Texas Health Science Center at Houston | Texas | May 18, 2017 |
| Komodo Health | All 50 states and the District of Columbia | August 21, 2017 |
| Michigan Value Collaborative | Michigan | March 19, 2018 |
| Clarify Health Solutions | 42 entire states and DC, and select counties in 7 states | March 19, 2018 |
| McKinsey & Company | All 50 states and the District of Columbia | October 10, 2018 |
| Nebraska Health Information Initiative | Iowa & Nebraska | November 2, 2018 |
| LexisNexis Risk Solutions | All 50 states and the District of Columbia | December 4, 2018 |
| Healthmonix | 43 entire states | January 7, 2019 |
| Blue Health Intelligence | All 50 states and the District of Columbia | May 14, 2019 |
| American Academy of Ophthalmology | All 50 states and the District of Columbia | June 11, 2019 |
| OCHIN Inc | 4 counties in California and 1 county in Massachusetts | June 21, 2019 |
| Archway Health | Maine | April 30, 2020 |
| Humana Healthcare Research, Inc | Kentucky and select counties in 8 states | October 1, 2019 |
| Wisconsin Hospital Association Information Center | Wisconsin | October 15, 2019 |
| Nascate | Iowa, South Dakota, Vermont and 30 counties in New York | February 24, 2020 |