Bloomberg News

Medicare to Disclose Payment Data on U.S. Doctors for First Time

April 03, 2014

U.S. Health Care

The U.S. Centers for Medicare and Medicaid Services will release data on its payments to individual physicians. It will show payments from the estimated $635 billion program to doctors for their medical services and procedures, how much those payments varied from their peers, and where they were performed. Photographer: Patrick Fallon/Bloomberg

Medicare, the U.S. health plan for the elderly and disabled, for the first time will release data on its payments to about 550,000 individual physicians.

The U.S. Centers for Medicare and Medicaid Services informed the American Medical Association in a letter that the data would be released April 9. It will show payments from the estimated $635 billion program to doctors for their medical services and procedures, how much those payments varied from their peers, and where they were performed.

The AMA and other physician associations have fought the release of details about doctors’ Medicare payments for more than three decades. Last May, a federal judge lifted a 33-year-old injunction that prohibited the Medicare agency from releasing any payment information that could be used to identify individual physicians, according to Bloomberg BNA.

“Data like these can shine a light on how care is delivered in the Medicare program,” Jonathan Blum, deputy administrator for the Medicare agency, said yesterday in a blog post announcing the decision. “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.”

While the AMA is “committed to transparency” and supports the release of some physician data, the group urges the government to allow individual doctors to review and correct their information prior to its public release, Ardis Dee Hoven, the association’s president, said in a statement.

‘Broad Approach’

“The AMA is concerned that CMS’ broad approach to releasing physician payment data will mislead the public into making inappropriate and potentially harmful treatment decisions and will result in unwarranted bias against physicians that can destroy careers,” she said.

After the injunction was lifted in May, the Obama administration began formulating a policy about how to handle requests for the information under the Freedom of Information Act. It published a regulation outlining the policy in January, and soon afterward “received multiple FOIA requests,” Blum said in the letter to the AMA.

Data on services that are provided to 10 or fewer patients won’t be released so that the patients can’t be identified, Blum said in his letter.

Medicare paid physicians about $70 billion in 2012 for services they performed in their offices, according to the program’s trustees. About 550,000 physicians billed the program that year, according to the Medicare Payment Advisory Commission, which makes recommendations to Congress on policy changes in the program.

Blum said that greater transparency in the health-care system will help to improve the quality of care, particularly since the enactment of the Patient Protection and Affordable Care Act.

“The public’s interest outweighs the privacy interest for the data that CMS plans to release,” he wrote.

To contact the reporter on this story: Alex Wayne in Washington at awayne3@bloomberg.net

To contact the editors responsible for this story: Reg Gale at rgale5@bloomberg.net Andrew Pollack, Bruce Rule


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