Searchable Databases Created From CMS Physician Data
By Christine Kern, contributing writer
A number of media outlets have created searchable databases based on the release of Medicare Part B payments, many lacking context or criteria.
In wake of the CMS release of the first-ever publication of Medicare Part B payments to individual physicians and physician practices last month, asreported by Health IT Outcomes, some journalists have created searchable national and regional databases for the public to explore.
The data was released in response to transparency demands raised by the court case requiring the agency to provide public access to physician billing records. According to the report, routine office visits accounted for the single largest share of Medicare physician billings in 2012, but amounted to just one one-seventh of the $77 billion paid by the government for physician services through the nation’s senior citizens healthcare program.
As Policy and Medicine reports, the data cover $77 billion in billing involving 880,000 practitioners, and every major publication spotlighted the story with most coverage focused on the physicians with the highest payments.
CMS released their data in a dozen giant, difficult-to-read spreadsheets. As the news coverage was unfolding, several national publications simultaneously created user-friendly databases with public access. The New York Times and Washington Post seemingly had their "Find a Doctor" tools ready the minute CMS released the payment data. The Wall Street Journal's database allows users to search by doctor name, company, specialty, city, or state.
Almost immediately, discrepancies between the databases began to emerge. Even regional publications jumped on the database bandwagon. Indeed, countless articles across the country ran variations of "Find Out How Much Your Doctor Receives from Medicare."
The problem with these searchable databases is that they do not tell the whole story. Without more context, the data is both unclear and unduly prejudicial to many physicians – especially those who practice in high-cost, specialized areas or who simply see a lot of patients.
While the public may learn who performs a high number of procedures, they will not be able to tell whether the patients needed the surgery, or whether they benefited from the surgery. In light of the data, physicians may be inclined to blindly choose cheaper alternatives, even if they believed through their expertise that patients would benefit by a more expensive drug or procedure. Lower costs are good, but physicians don't really need the government or journalists who haven't studied medicine questioning their treatment practices.
The raw data also does not make it clear that Medicare payment amounts do not equal physician income, but also include costs of medications, supplies, and operating costs. And another aspect of the data that has emerged is that in many instances, multiple doctors will use a single NPI number, thus making it appear that one particular physician is drawing in large amounts of Medicare funding.