Blog | Tuesday, June 3, 2014

Medicare reveals physician payments


With little fanfare, the federal government made public all of the “Part B” Medicare expenditures from 2012. For the first time, it became possible to view by physician the types of services being billed, the number of each type, the charges, and the actual payment from Medicare.

According to the CMS press release this was being done “as part of the Obama administration’s work to make our health care system more transparent, affordable, and accountable.”

Major news organizations, such as the New York Times, quickly posted on line interactive tools that allow users to determine “how much Medicare pays for your doctor’s care“ and ran a variety of companion articles about the distribution of payments and profiles of a few of the “best paid.”

The American Medical Association was quick to point out some of the potential shortcomings of the dataset, including the fact that some of the physician profiles may be quite misleading, as in the cases where several residents or mid-level providers may have provided services under the supervision of a single Medicare provider, or where information may be missing or in error. In addition, the data are limited to services provided to Medicare beneficiaries, and therefore are not comprehensive profiles of physicians’ practices.

Despite the limitations, the move by CMS to make these data public seems to me to be a step in the right direction. If the data are confusing, professional societies and the news media should explain them. If they are incomplete or in error, then making them public should stimulate their improvement. If they are limited, they are still better than nothing. We should not stand in the way of shedding light on where all of those billions of dollars that Medicare spends go. Taking public funds should come with public accountability.

What do you think?

Ira S. Nash, MD, FACP, is the senior vice president and executive director of the North Shore-LIJ Medical Group, and a professor of Cardiology and Population Health at Hofstra North Shore-LIJ School of Medicine. He is Board Certified in Internal Medicine and Cardiovascular Diseases and was in the private practice of cardiology before joining the full-time faculty of Massachusetts General Hospital. He then held a number of senior positions at Mount Sinai Medical Center prior to joining North Shore-LIJ. He is married with two daughters and enjoys cars, reading biographies and histories, and following his favorite baseball team, the New York Yankees, when not practicing medicine. This post originally appeared at his blog, Ausculation.