CMS Announces New Data Warehousing Initiative

Published February 1, 2007

In an effort to limit waste, fraud, and abuse in American health care, the federal Centers for Medicare and Medicaid Services (CMS) announced on October 11 a new data warehousing initiative intended to centralize medical information on Medicare and Medicaid beneficiaries.

The program, called One-Pi, or Program Integrity, represents a partnership between CMS and Teradata, a private information solutions firm based in Dayton, Ohio. According to a November 6 news release issued by NCR Government Systems LLC–Teradata’s parent company–“by utilizing the firm’s skill in database management, the Centers for Medicare and Medicaid Services organization (CMS) is preparing to take a new, more advanced approach to detect and reduce fraud and abuse.”

According to the news release, CMS annually disseminates more data–to researchers, policy groups, associations, medical groups, and private citizens–than any other federal agency or private-sector company.

“The enormous quantities of detailed, dynamic data managed by the Centers for Medicare and Medicaid Services require an enterprise-class intelligence environment that can provide speed, flexibility, and scalability at a highly advanced level,” NCR President Bill Cooper stated in the release. “The Teradata platform is designed to meet escalating requirements for large and growing organizations amid rising complexity and data volumes.”

Catalyst for Change

One of the new demands placed on CMS is the increase in benefits resulting from the Medicare Modernization Act, a federal law passed in 2003 that added a prescription drug benefit to Medicare and expanded recipients’ health plan choices.

Medicare is also strained by increasing claims from aging Baby Boomers. The growing data management requirements led CMS to retain NCR and its subsidiary Teradata to help organize and manage the information.

NCR Chief Information Officer Dr. Gary Christoph explained “enterprise intelligence” is a valuable investment for both the public and private sectors.

“Organizations that are willing to exercise thought leadership at an executive level and invest in a centralized, enterprise-class intelligence environment have shown they benefit in the megamillions of dollars–not only in return on investment, but also in lower total cost of ownership,” Christoph said.

Privacy Protection

Some health policy analysts, however, are concerned that centralizing millions of people’s personal medical data will pave the way for serious violations of personal privacy.

“The only way the public can be protected from the politicization of medicine is to not centralize the data,” said Twila Brase, president of the Citizens’ Council on Health Care, a free-market group based in Minnesota.

The new data warehouse is “moving in the wrong direction,” Brase said, adding that a better alternative would be to abandon the traditional Medicare and Medicaid programs altogether and give their funds directly to patients.

Such defined contributions to individual patients, Brase said, would eliminate the bureaucracy and political pressures that are “controlling and confining the practice of medicine.”

Additionally, Brase said, the proposed database would create a “government-derived evidence base that no one can refute,” leading to “more government interference in the practice of medicine.”

David Salvo ([email protected]) is a freelance writer in Bloomington, Indiana.