- The Centers for Medicare and Medicaid Services on Monday said it will releasing Medicare physician-payment records to the public on a yearly basis.
- A spokeswoman for CMS said the agency decided to update the data annually despite ongoing concerns of doctors' groups, but did not give a date for the next release.
- In April of 2014, CMS released the data on Medicare payments to 880,000 medical providers in 2012, totaling $77 billion—the first release of this kind of information. The data lists exact services for which physicians billed Medicare, the average payments for each service and the number of patients who received each service.
CMS' latest announcement is consistent with the healthcare industry's focus on quality and transparency. And in doing so, it will give potential fraudsters some pause before trying to pull fast ones on the government. But the question remains as to whether a physician's right to privacy outweighs public interest on how dollars are spent, and whether the raw data is refined enough to meaningful to consumers.
The American Medical Association fought the release of this information from the beginning, urging the Department of Health and Human Services not to release any more payment information before making improvements to the data set.
In a letter to CMS following the original release last year, the association outlined a series of concerns, particularly about whether the data painted an accurate picture. "Instead of new insights into healthcare, the recently-released data have brought a series of sensationalist news stories, the majority of which inaccurately reported on the data, confused the public, and in some cases may have encouraged patients to make care changes that were not in their best interest," Dr. James Madara, the AMA's executive vice president and CEO, wrote in a letter to former CMS Administrator Marilyn Tavenner.
The dataset does have its limits, although the jury is still out on whether those limitations are as harmful as the association says. Perhaps the most severe limitation is that the data set is only a slice of a physician's whole patient population because it solely covers Medicare patients. That makes it difficult to create comparative figures, like the total number of times a physician performs a procedure. Expect this announcement to re-open what was already a sensitive debate.
The AMA has not yet released a statement regarding the announcement. It may have accepted the inevitable federal march towards transparency, an attitude that former Medicare head Gail Wilensky suggests would be in the best interest of all physicians:
"As imperfect as the data may be," Wilensky said, "its continued release makes it in the physicians' interest to make it better—more useful and accurate—instead of just fighting its release."
Want to read more? You may enjoy this story on how to the AMA, the Medicare data is too raw to use.