HHS Data Dump Opens Physicians' Finances to Public Scrutiny

AAFP Will Use Data to Highlight Payment Inequities

April 11, 2014 03:42 pm Sheri Porter

On April 9, CMS announced that it had made public a data set of information(www.cms.gov) that contains financial information -- including billing and Medicare payment details -- on some 880,000 physicians who were paid about $77 billion in 2012 for services provided to patients as part of the Medicare Part B fee-for-service program.

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In an HHS press release(www.hhs.gov) posted the same day, then HHS Secretary Kathleen Sebelius characterized the data dump as a way of providing unprecedented transparency to consumers about the medical services physicians provide and how much physicians are paid for those services.

"Currently consumers have limited information about how physicians and other health care professionals practice medicine," said Sebelius. "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 health care spending and physician practice patterns."

The AAFP and numerous other physician organizations expressed concerns about the release of such data as recently as September 2013. But the final CMS action was not unprecedented; last May, CMS released similar data on hospital charges for public consumption.

Story highlights
  • CMS has released payment data on services and procedures for Medicare patients provided by individual physicians and other health care professionals.
  • The data dump was described by HHS as an effort to provide transparency to consumers about how much physicians are paid for the services they provide.
  • The AAFP expects to use the data to highlight payment inequities between family physicians and other medical specialties.

AAFP President Reid Blackwelder, M.D., of Kingsport, Tenn., responded to the news with a message some family physicians may not have considered.

"The release of this kind of financial and service-related data might feel threatening to some family physicians," said Blackwelder. "That's understandable given that physicians had no opportunity to review or correct data before it was released and, currently, have no mechanism to appeal inaccuracies."

However, continued Blackwelder, "I'd like to reassure family physicians that this action taken by CMS will provide a great opportunity for the Academy to highlight the complexity of care that family physicians provide.

"Some initial media reports have shown the wide variation in total payments made among various medical specialties. When that data set is further mined and studied, it won't be difficult to make the case -- using hard evidence -- that family physicians provide comprehensive and time-intensive health care to their patients and, yet, are near the bottom of the list in terms of payment for those services."

A one-page informational brief just posted by the AAFP provides more detail about what's in the data now available for public viewing. The brief also includes links to online tools posted by the The New York Times(www.nytimes.com) and The Wall Street Journal(projects.wsj.com) that allow users to search the data by physician name, specialty and city/ZIP code.

In addition, the AAFP is working on more resources to address physician concerns around such issues as

  • the implications of possible intense media scrutiny of physicians' financial records,
  • the possibility of practice audits triggered by released data, and
  • the kinds of questions patients likely will ask and how to respond.

Kent Moore, the AAFP's senior strategist for physician payment is helping create those member resources. "We're looking at every aspect of this situation and anticipating other questions members will have," said Moore. "Our goal is to help family physicians understand what the release of this information means to them."

Related AAFP News Coverage
CMS Modifies Policy on Disclosing Individual Physician Payment Data
Agency Will Decide Whether to Release Information on Case-by-Case Basis


Safeguards, Protections Must Accompany Release of Medicare Physician Claims Data, Say AAFP, Others

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