Perspective: CMS Release of Physician Payments

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MMS President Ronald Dunlap:   perspective needed on Medicare payments.

When the Centers for Medicare and Medicaid Services (CMS) last month  released its physician payment data for 2012, the agency described it as a major step forward for health care transparency, and CMS administrators and Congressional representatives alike extolled the virtues of making such information public.

The proposed action wasn’t without controversy. Prior to its release, nearly 100 national, state, and specialty medical societies signed on to a letter sent in September 2013 to CMS citing physician concerns about the release of raw data and opposing its release, saying it “should be limited for specific purposes and with appropriate safeguards.”

The letter further stated that the societies welcomed “the opportunity to work with CMS to improve meaningful and appropriate access to this information and recognize the potential value and importance of Medicare physician claims data,” and it encouraged CMS to partner with physicians to develop policies that will “promote the reliable and effective use of this information” and cited many concerns physicians had about releasing the data.

CMS released the raw data on April 9, and, predictably, news coverage was widespread across the nation.  The Wall Street Journal wrote that “The trove of Medicare data released Wednesday shows a wide cast of characters in the top ranks of the highest-reimbursed doctors, and reveals as much about the limits of the newly public billing records as it does about medical practice.”

The New York Times noted the limits of the data as well, writing that “Many other doctors worried that the data released was incomplete and often misleading. In some cases, enormous payments that seem to be going to one doctor are actually distributed to multiple others. But the data tables do not reveal that the money was shared.”  Much of the news coverage in the Commonwealth focused on local physicians receiving large payments.

Reaction from physicians was mixed; some were outraged, some were surprised, some were resigned to the data’s release as part of the continuing trend in transparency.  CMS released the data with a minimum of explanation, saying only that there may be legitimate reasons why doctors get high Medicare payments. But physician payments, from whatever source, are part of the highly complex nature of health care spending and require some perspective for better understanding.

MMS President Dr. Ronald Dunlap offers such a perspective in this commentary, published May 2 on WBUR’s CommonHealth website.

 

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