Dive Brief:
- Previously-undisclosed Medicare data now details an additional $12.4 billion that was paid to providers in 2012 but had been redacted from the original data release in 2014.
- The additional payments, which bring the 2012 total up to $90 billion, were for services that were provided to only a small number of patients, but were sometimes extremely high-cost.
- CMS had originally excluded the data to protect patient privacy because the providers involved had fewer than 11 Medicare beneficiaries.
Dive Insight:
The additional data provides a more complete view of Medicare payments. It still does not reveal procedures with low beneficiary counts, but does reveal the payments for those procedures to each provider.
The most notable impact is in the revealing of higher total payments to specialists, typically due to expensive treatments for conditions such as hemophilia.
According to the CMS, the new methodology is intended to provide more transparency to the public. Although physicians are still omitted from the data if they treated fewer than 11 patients overall, "the totals displayed in the file are extremely close" to Medicare's internal records, a spokeswoman told the Wall Street Journal.
Despite the new methodology, the AMA continues to argue that the data limitations result in misperceptions about payments to specific physician practices.