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On April 9, 2014 CMS released to the public finalized 2012 fee-for-service (FFS) Medicare Physician Fee Schedule (Part B) payment information linked to the National Provider Identifier (NPI) of more than 880,000 health care professionals in all 50 states who collectively received $77 billion in payments. This is the first time specific information regarding Medicare payments provided to identifiable physicians and other healthcare professionals has been made public. CMS made public the following information for each paid-for service ---- as identified by its Healthcare Common Procedure Coding System (HCPCS) code:
No identifiable patient data was released and information was not provided for physicians and other healthcare professionals who submitted claims for fewer than 11 Medicare beneficiaries for that year.
Data was released as a downloadable raw data file set available at https://www.cms.gov/Research-Statistics-Data-and-Systems/Statistics-Trends-and-Reports/Medicare-Provider-Charge-Data/Physician-and-Other-Supplier.html.
From this site, data can be downloaded as a:
The CMS site includes a detailed description of how the released data is defined, how it was developed and includes the following brief cautionary statement regarding the limitations of this information:
"… the dataset has a number of limitations. Of particular importance is the fact that the data may not be representative of a physician's entire practice as it only includes information on Medicare fee-for-service beneficiaries. In addition, the data are not intended to indicate the quality of care provided and are not risk-adjusted to account for differences in underlying severity of disease of patient populations..."
Additional user-friendly sources for this data have been developed by the New York Times (http://www.nytimes.com/interactive/2014/04/09/health/medicare-doctor-database.html), and Washington Post (http://www.washingtonpost.com/wp-srv/special/national/medicare-doctors-database/).
On April 24, 2014, CMS released a more user-friendly data source at https://data.cms.gov/use-agreement/data-limitations/provider-explorer.
CMS had been banned from fulfilling requests through the Freedom of Information Act (FOIA) for identifiable Medicare provider payment information as a result of a 1979 court injunction stemming from a lawsuit that the American Medical Association and the Florida Medical Association filed based upon invasion of physician privacy concerns. This injunction was lifted by a federal judge in May, 2013 and CMS announced in a January 2014 Federal Register notice a required change in policy to release such information through FOIA processes as a result this judiciary action.
This decision is consistent with a number of recent actions by HHS/CMS in support of greater healthcare data transparency to improve healthcare quality, efficiency and safety. These actions include:
ACP has extensive policy in support of transparency throughout the healthcare system. This policy is most clearly articulated in the 2010 policy paper "Healthcare Transparency --- Focus on Price and Clinical Performance Information' available at http://www.acponline.org/advocacy/current_policy_papers/transparency.pdf. The policy paper reflects the College's general support for the concept of healthcare transparency contingent on the reported information meeting a number of important criteria including the information being:
Based on this policy, while the College supports the public release of this information, it has concerns regarding the process and format of this release. More specifically, the College would have preferred that:
Despite unfortunate and ill-informed comments in a related CMS press release and articles found in mass-media sources, the consensus of the healthcare policy community is that this information in its present form is of little or no value to patients/consumers. More relevant uses, generally requiring coupling with other data and analytic software, include:
Problems reported to the College by its members and others include:
The College, both individually and in collaboration with other medical societies, has had several conversations with CMS to address problems with the current data release, and to minimize problems with releases in the future. CMS has already agreed to develop a process to correct any inaccurate data reported in this current release. They have also agreed to take into consideration in future releases our call for increased information about what the information means and its limitations ---- to limit the likelihood of misinterpretation.
ACP also, on its own and with other medical societies, plans to develop information for its members and the public that should allow for better understanding of the data. This FAQ document is an example of this effort.