Qualified Entity (QE)
What is a qualified entity (QE)?
A qualified entity is an individual, governmental agency, organization, or business that provides care or care placement services for vulnerable populations. Qualified entities may be private, public, for-profit, not-for-profit, or voluntary, comprising contractors, employees, or volunteers.
Vulnerable populations that qualified entities provide care or services may include:
- Children
- Individuals with disabilities
- The elderly
Being classified as a qualified entity allows an organization to partake in the CMS Qualified Entity (QE) Program, which allows organizations to receive Medicare claims data to evaluate provider performance. This program is also known as the Medicare Data Sharing for Performance Measurement Program.
How does a qualified entity improve healthcare?
A qualified entity provides care and services for vulnerable populations. The care provided for these populations by qualified entities can include treatment, care, training, education, instruction, or supervision. To be considered a qualified entity, the entity’s primary function must be to provide these services to vulnerable populations.
Additionally, as a qualified entity, the organization can evaluate provider performance through the CMS QE Program, which can then help these vulnerable populations receive better healthcare from all providers.