- On Thursday, the American Medical Association submitted a letter to CMS Administrator Marilyn Tavenner, reasserting its warnings about the limitations of the raw Medicare data released last month.
- The AMA insists that physicians should be given the opportunity to “correct and explain” their data. While CMS argues that this is unnecessary because physicians themselves generate the data, the AMA writes, “We do not accept that that all errors in the database were put there by physicians.”
- According to the letter, the raw data release has resulted in “sensationalist news stories, the majority of which inaccurately reported on the data, confused the public, and … may have encouraged patients to make care changes that were not in their best interest.” The AMA calls for CMS to display the limitations of the data more prominently, and provide more explanation to users.
The AMA raises legitimate concerns about the clarity and usefulness of the Medicare data. While proponents call the release a victory for increased transparency, some critics have blasted it as a symbolic victory that, lacking context, provides little usable information; the AMA expressed concern in the letter that CMS is not devoting sufficient attention to ensuring the data is interpreted properly and used appropriately.
The letter includes a list of the following 10 major limitations to the data, according to the AMA:
The data could contain errors; Care quality cannot be assessed from the information reported; The reported number of services could be misleading; Billed charges and payments are not the same; Important information is missing; Reimbursement for drugs purchased and administered by physicians is co-mingled with other physician payments; The data set does not represent the physician’s whole population; Payment amounts are based on where the service was provided; The data set does not enable clear comparisons of physicians; Coding and billing rules differ over time and across regions.