Medicare Data to Be Annually Released

According to The Wall Street Journal, the Centers for Medicare and Medicaid Services (CMS) will begin releasing Medicare physician-payment records every year.

In April 2014, the CMS released the 2012 Medicare data on payments to 880,000 medical providers, which totaled $77 billion. This was the first time the Medicare data has been released since a 1979 injunction prohibited Medicare from disclosing its payments to doctors. The injunction was put in place based on efforts by the the American Medical Association, which argued a doctor’s right to privacy outweighed the public’s interest in knowing how tax dollars were spent.

The Medicare data released in April included most payments to doctors, laboratories, ambulance companies and other medical providers under Medicare Part B, which makes up about one-seventh of the program’s nearly $600 billion in annual expenditures.

Frederick M. Azar, MD, president of the American Association of Orthopaedic Surgeons (AAOS), stated that the AAOS “supports increased transparency and is committed to improving the quality of care of all patients,” but is concerned that because these data are raw and not risk-adjusted, they may be misleading to the average patient, which does not take into consideration:

• the age and overall health of patients seen,
• their degree that a patient has the simultaneous presence of two chronic diseases or conditions, and
• the severity of the conditions being treated, which makes it challenging to compare or assess physicians’ cost for similarly coded procedures and treatments.

Dr. Azar also noted that the Medicare data may not reflect actual revenue received by physicians.

On the other hand, Ari Tulla, chief executive and co-founder of BetterDoctor.com, has incorporated the information into a searchable national database that already includes a range of data sources to help create a review system incorporating this data in addition to peer reviews, consumer feedback, academic history, and hospital quality.

However, most agree that the Medicare data transparency will hopefully improve health care costs. As quoted in the Wall Street Journal, “The cost of health care is soaring and we really need to get a handle on where the money is going,” said William B. Jordan, president-elect of the National Physicians Alliance, a nonprofit organization. “I don’t think you can do that without transparency.”

The agency has not announced when the next batch of data would be released.