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Medicare’s data release aims to increase transparency
e-Reports, May 5, 2014
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If you see Medicare patients, you may know that the Centers for Medicare & Medicaid Services (CMS) recently released payment data on you and more than 880,000 of your colleagues nationwide.

The report names physicians who collectively received $77 billion in Medicare payments in 2012, under the Medicare Part B fee-for-service program. The purpose of the data release is to provide transparency, allowing patients to compare services and charges.

The information is available on the CMS website and is expected to be released annually. Find the interactive search tool on the CMS website.

The data includes:

  • Your name and address
  • Specialty
  • Number of Medicare services
  • Average submitted charges
  • Standard deviation in submitted charges
  • Average Medicare payment

“Data transparency is a key aspect of transformation of the health care delivery system,” said CMS Administrator Marilyn Tavenner. “While there’s more work ahead, this data release will help beneficiaries and consumers better understand how care is delivered through the Medicare program.”

Fort Wayne ophthalmologist Jonathan Walker, M.D., hopes the information will help physicians and health care economists benchmark behaviors.

Dr. Jonathan Walker
Jonathan Walker, M.D., Fort Wayne

“Transparency is crucial to helping patients make decisions,” he said. “However, I wish CMS had separated out the drug costs from the amount paid for the physician’s services.” Dr. Walker added that while the information is easy to misinterpret, it can provide a benchmark on behaviors.

“The information will hopefully help people understand the cost of drugs in our health care system,” he said. “We are all grateful to drug companies for new medicines, but we have to keep in mind that Medicare is forbidden by law to bargain over the cost of drugs. Most people do not realize this.”

ISMA Director of Practice Management Sandra Miller agreed the information is out of context. She explained that Medicare payments do not reflect actual profit and do not take into account a physician’s cost for certain medications, equipment, staff, insurance and other overhead items.

“The release of the data is a step toward transparency, and it can help patients see where the money is going. But it doesn’t tell the whole story,” she explained. “Physicians can use this as an opportunity to have a conversation with patients to discuss what the data really represents.”

Krieg DeVault offers suggestions on how you can protect yourself with the release of this information. Find them at Krieg DeVault's website.

Find a detailed history of the court cases leading to the release of Medicare data here.

Copyright: Information written and displayed on www.ismanet.org is the property of ISMA and may not be reproduced without expressed written permission of the Indiana State Medical Association.

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