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 |
| IQVIA | All 50 States and the District of Columbia | August 12, 2020 |
| Axxess | All 50 States and the District of Columbia | March 2, 2022 |
| Populi Inc. | All 50 States and the District of Columbia | May 17, 2022 |