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Health Team

New Medicare data could shed light into doctor payments

Posted April 9

The federal government released a massive dataset April 9, 2014, detailing payments to doctors through Medicare.

— The federal government has for the first time released data detailing how much doctors are paid for medical procedures through Medicare.

To protect privacy, the data does not detail payments for individual patients. But it does list average payments from Medicare's Part B program to more than 880,000 physicians and health care facilities, totaling about $77 billion in 2012.

Health researchers such as Donald Taylor, associate professor of public policy at Duke University, said the new data will help provide a better understanding of the costs of health care across the country.

"This gives a pretty good backdrop of the health care system that's taking care of the elderly in the country, and that's the group of patients that are the sickest and the highest utilizers of care," Taylor said. "It really does help to fill a part of the payment side of the picture of the health care system."

But the data are far from complete. Covering only the so-called "fee-for-service" program, Taylor said payment data for patients enrolled in private plans through Medicare Advantage aren't included. That omits about one in four Medicare enrollees.

"In a part of the country where a large portion of the Medicare beneficiaries are on Medicare Advantage plans, this data will be a less complete picture," Taylor said.

Also absent are any data on the quality of care or the outcomes of the procedures, so Taylor said some conclusions will be difficult to draw.

Although the dataset may be useful for rooting out outlier cases of fraud and abuse in the Medicare system, he said he has doubts about whether it will be a useful tool for everyday consumers.

"It's not likely that my grandmother's going to download the data on her iPhone and figure out which doctor's going to replace her hip," Taylor said. "That's just not going to happen."

But he said the increase in transparency represents a positive trend, especially since Wednesday's release comes one year after the Centers for Medicare and Medicaid Services provided another dataset containing the costs of procedures at hospitals across the country.

"This helps fill in part of the puzzle for the big picture Medicare program," Taylor said.

When it comes to controlling health care costs however, the devil is in the details.

"In the end, that's where the real difficulty comes: the general notion that we spend too much and the individuals willing to alter their healthcare seeking behavior," Taylor said.

He said that same discrepancy applies to those who are dissatisfied with the health care system but happy with their doctors.

"You can think of it as being similar to Congress," Taylor said. "People say they hate Congress, but they keep on re-electing their congressman or woman."

2 Comments

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  • JustOneGodLessThanU Apr 10, 3:06 p.m.

    This transparency is good.

  • Alex25 Apr 10, 12:02 p.m.

    The waste and fraud in all of Govt at all levels is never not stunning.

    And it's MY money...