Improvements to the Open Payments reporting system are welcome, but don’t go far enough.
That was the message from the American Medical Association upon the July 1 release of another round of data in the financial disclosure system created by the Affordable Care Act.
CMS “has improved our interface for both collecting and reporting this data about compensation and other payments between drug and medical device manufacturers and physicians and teaching hospitals,” Dr. Shantanu Agrawal, CMS deputy administrator and director of the Center for Program Integrity, said in a statement.
“While we appreciate the efforts of the Centers for Medicare & Medicaid Services to verify the data submitted by industry, the complicated and cumbersome process for physicians to register to review their data and seek correction of any inaccuracies continues to hinder their participation in the validation process,” the AMA said in a statement.
Dr. David O. Barbe, a family physician in Mountain Grove, Mo., noted that “the ability to navigate [Open Payments] has substantially improved since the first iteration of this. You can get around the website pretty well. ... You can sort the data. You can search on individuals. You can sort it by large amounts, either by individual physician or by payer.”
However, the approach used still makes it extremely difficult for determining the validity and accuracy of the information that is being presented, said Dr. Barbe, a member of the AMA Board of Trustees.
“I am looking at one physician here who has 511 total transactions,” he said. “There is no way that that physician can legitimately validate or even refute those transactions. I can’t imagine what the record-keeping would be like if he were to attempt to track 511 transactions from industry over the course of the year.”
The complexity of tracking all those data could be the reason so few transactions have been disputed. In 2014, CMS reported data on 10.8 million general payments to physicians and teaching hospitals; 1,732 were transactions disputed. In 2013, data were reported on 4.1 million general payments, with 880 disputed. The value of general payments rose to $2.6 billion ($5.1 million disputed) from $972 million (nearly $2 million disputed).
Open Payments captured payments to 607,000 physicians and to 1,121 teaching hospitals made by 1,444 companies in 2014, up from 470,000 physicians and 1,019 teaching hospitals receiving payments from 1,347 companies in 2013.
But Dr. Barbe said that his primary complaint remains that the information comes without any context and really doesn’t convey any useful information. They’re just data.
“To suppose that because he has a lot of transactions, that means there’s some kind of illicit or nefarious relationship that the physician has with industry, I think is also not necessarily a conclusion one can draw.”