Practice Economics

Medicare to release physician pay data in April


 

Medicare officials are preparing to publish data on the specific services and procedures performed by individual physicians and how much they were paid by the program. The data could be posted on the Medicare website as early as April 9.

This will be the first time the federal government has published data on individual physicians.

Dr. Ardis Dee Hoven

But the news is being greeted cautiously by physicians. The American Medical Association is asking the Centers for Medicare & Medicaid Services to let physicians review and correct their data before it is publicly released.

"This safeguard is not only practical but was recognized and included in other data release proposals," Dr. Ardis Dee Hoven, AMA president, said in a statement. "Additionally, any analysis of the data released should note methodologies to ensure understanding of its limitations. Taking an approach that provides no assurances of accuracy of the data or explanations of its limitations will not allow patients to draw meaningful conclusions about the quality of care."

Dr. Reid Blackwelder, president of the American Academy of Family Physicians, agreed. While the AAFP is generally supportive of greater transparency of physician payment data, Dr. Blackwelder said the context can often be missed when releasing this type of data.

"It may not be quite as straightforward as it might appear," he said.

Dr. Reid Blackwelder

The CMS announced in January that it would reverse more than 30 years of policy that restricted the release of that information. The policy shift came after a federal court lifted an injunction that had previously barred the agency from making its database of Medicare physician claims public. Agency officials said then that they would use a "case-by-case" approach when reviewing the data requests.

Since then, the CMS has received multiple Freedom of Information Act requests seeking Medicare physician data, according to Jonathan Blum, principal deputy administrator for CMS.

In an April 2 letter to the American Medical Association, the CMS said that it would begin releasing the data on its web site no sooner than April 9. The information will be organized by National Provider Identifier, Healthcare Common Procedure Coding System (HCPCS) code, and by place of service. The data set will include the average and the standard deviation for submitted charges, allowed amounts, and Medicare payments for services performed in 2012.

Jonathan Blum

"Data like these can shine a light on how care is delivered in the Medicare program," Mr. Blum wrote in a blog post "They can help consumers compare the services provided and payments received by individual health care providers. Businesses and consumers alike can use these data to drive decision-making and reward quality, cost-effective care."

The data being released will provide information on more than 880,000 health care providers in all states. Collectively, these providers received $77 billion from Medicare Part B in 2012.

The CMS will not release personally identifiable information about beneficiaries and will redact all data in cases in which a data set has fewer than 11 beneficiaries.

mschneider@frontlinemedcom.com

On Twitter @maryellenny

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