A Qualified Entity (QE) refers to an organization that has met specific criteria set by the Centers for Medicare & Medicaid Services (CMS) to access Medicare claims data for the purpose of analyzing healthcare quality and efficiency. These entities use the data to produce public reports that inform consumers and stakeholders about healthcare performance. QEs play a critical role in improving healthcare transparency by analyzing and disseminating crucial information.
Qualified Entities are essential in the healthcare landscape as they enhance transparency and accountability by providing data-driven insights. Their analyses help in identifying patterns, trends, and areas for improvement across various healthcare services, ultimately driving better health outcomes. By making healthcare performance data publicly available, QEs empower patients and providers to make more informed decisions, leading to more efficient and effective healthcare delivery.