PurpleLab Receives CMS Certification Status as Qualified Entity for Access to Medicare Claims Data

PurpleLab, Inc. announced today it has received certification as a Qualified Entity from the Centers for Medicaid & Medicare Services (CMS). The CMS Qualified Entity (QE) Program (also known as the Medicare Data Sharing for Performance Measurement Program), enables certified organizations to receive 100% of the Medicare claims data under Parts A, B, and D for use in evaluating provider performance. There are currently less than 20 companies that have earned this rigorous certification. 

With the market considering different pay models and value-based care payment methods, PurpleLab’s clients require deeper data and analytic insights across the care continuum. Integrating nationwide Medicare claims onto the company’s HealthNexus™ platform ensures the company captures commercial and public payer claims data for more comprehensive and meaningful analytics.

“PurpleLab is committed to measuring the metrics that are critical to accelerating the delivery of actionable, predictive insights.” commented, CEO & Founder, Mark Brosso. “We are thrilled to receive Qualified Entity status and leverage this data to drive greater transparency throughout the healthcare ecosystem. Ultimately we want to improve patient outcomes earlier in their journey.”

“The QE data will support ongoing programs at PurpleLab, combining information from our commercial, Medicaid and Social Determinants of Health (SDOH) data sets along with the Medicare data to reveal how provider practices are similar or vary across different product lines.” commented Chief Medical Information Officer, Russell Robbins, M.D. “In addition, PurpleLab has developed a proprietary provider scoring methodology which was evaluated by independent reviewers and was accepted as a part of our QE application. This newly endorsed CMS methodology will benefit both consumers and healthcare providers in understanding quality, effectiveness, and innovations in healthcare.”  

QEs are required annually to use Medicare claims data to generate public performance reports for providers and suppliers on measures of quality, efficiency, effectiveness and resource use. QEs may also use the Medicare data to provide or sell non-public reports to authorized users. 

PurpleLab is now undergoing the Phase II & III portions of the application process prior to receiving the data. 

About PurpleLab, Inc.

PurpleLab is a health-tech company focused on driving immediate and decisive action based on precise insights from fully integrated real-world data. With HealthNexus™, the company’s sophisticated no-code analytics platform, healthcare stakeholders are empowered with the real-world evidence they need to solve conventional, new, and emerging challenges. Life science, payers, providers, and advertising companies derive value faster, more cost effectively, and with significantly greater confidence.