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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 (October 13, 2017)

Name of Lead Entity

Region(s) in which QE will publicly report provider performance

Date of QE Certification

Oregon Health Care Quality Corporation

Oregon

August 31, 2012

The Health Collaborative

10 counties in Southwestern Ohio and Northeastern Kentucky

August 31, 2012

HealthInsight

Utah

January 18, 2013
California Healthcare Performance Information System California February 6, 2013
Minnesota Community Measurement Minnesota, 6 counties in North Dakota, 7 counties in South Dakota, and 11 counties in Wisconsin August 5, 2013
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
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
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