HHS releases Medicare physician payment data

In a historic move, Department of Health & Human Services (HHS) Secretary Kathleen Sebelius has released data on services and procedures provided to Medicare beneficiaries by physicians and other healthcare professionals for the year of 2012.

The new data provide payment and submitted charges for services and procedures for more than 880,000 distinct healthcare providers who collectively received $77 billion in Medicare payments under the Medicare Part B Fee-For-Service program.

The data allow for a wide range of analyses that compare 6,000 different types of services and procedures provided, as well as payments received by individual healthcare providers.

“Currently, consumers have limited information about how physicians and other healthcare professionals practice medicine,” said Sebelius in a statement. “This data will help fill that gap by offering insight into the Medicare portion of a physician’s practice. The data released today afford researchers, policymakers and the public a new window into healthcare spending and physician practice patterns.”

A small fraction of the total Medicare providers had received a sizeable portion of total funding, according to several newspaper reports that immediately followed the data's release. In 2012, 100 doctors received a total of $610 million, ranging from a Florida ophthalmologist who was paid $21 million by Medicare to dozens of doctors—mostly eye and cancer specialists—who received more than $4 million each for that year, according to the New York Times.

In addition, Medicare paid nearly 4,000 physicians in excess of $1 million each, reports the Washington Post.

The American Medical Association (AMA), which lobbied against the release of the data, expressed concern that the glut of information could unfairly target specific physicians.

"We believe that the broad data dump today by CMS has significant shortcomings regarding the accuracy and value of the medical services rendered by physicians. Releasing the data without context will likely lead to inaccuracies, misinterpretations, false conclusions and other unintended consequences,” said AMA President Ardis Dee Hoven, MD, in a statement.

Hoven added that data on quality, value and outcomes are needed to provide more context into physician performance.

The release of the physician payment data follows last year’s release of hospital charge data, which allowed consumers to compare what hospitals charge for common inpatient and outpatient services across the country.

The physician dataset is available here.

Around the web

The American College of Cardiology has shared its perspective on new CMS payment policies, highlighting revenue concerns while providing key details for cardiologists and other cardiology professionals. 

As debate simmers over how best to regulate AI, experts continue to offer guidance on where to start, how to proceed and what to emphasize. A new resource models its recommendations on what its authors call the “SETO Loop.”

FDA Commissioner Robert Califf, MD, said the clinical community needs to combat health misinformation at a grassroots level. He warned that patients are immersed in a "sea of misinformation without a compass."

Trimed Popup
Trimed Popup