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, Massachusetts July 14, 2020
Wisconsin Hospital Association Information Center Wisconsin and 23 counties in Minnesota October 15, 2019
Humana Healthcare Research, Inc Kentucky and select counties in 8 states October 1, 2019
The Health Collaborative 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 Missouri, 53 counties in Illinois, 30 counties in Kansas September 17, 2013
Health Care Cost Institute 49 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
Regents of the University of Michigan Michigan March 19, 2018
Clarify Health Solutions All 50 states and the District of Columbia March 19, 2018
McKinsey & Company All 50 states and the District of Columbia October 10, 2018
CyncHealth- Quasi QE Iowa & Nebraska November 2, 2018
LexisNexis Risk Solutions All 50 states and the District of Columbia December 4, 2018
Healthmonix- Quasi QE All 50 states and the District of Columbia January 7, 2019
Blue Health Intelligence All 50 states and the District of Columbia May 14, 2019
OCHIN Inc 4 counties in California and 1 county in Massachusetts June 21, 2019
Archway Health 29 states and the District of Columbia April 30, 2020
Nascate Iowa, South Dakota, Vermont and 30 counties in New York February 24, 2020
Comagine Oregon April 14, 2020
Cotiviti 49 states August 26, 2020
Trella Health All 50 states and the District of Columbia May 21, 2021
Vizient Inc All 50 states and the District of Columbia July 28,2021
Page Last Modified:
12/01/2021 08:00 PM