Public release of physician payments: Chaos or clarity?

The Centers for Medicare & Medicaid Services (CMS) may begin posting information about physician payments as early as April 9, a move the government says will facilitate transparency and medical groups charge will foster confusion.  

CMS may begin publicly releasing data about the medical services and procedures provided by physicians, including data on related charges and payments.

“[T]his public data set will include number of services, average submitted charges and standard deviation in submitted charges, average allowed amount and standard deviation in allowed amount, average Medicare payment and standard deviation in Medicare payment, and a count of unique beneficiaries treated,” wrote Jonathan Blum, principal deputy administrator for the U.S. Department of Health and Human Services in a letter explaining the reasoning for releasing the information on its website.

American College of Cardiology (ACC) President Patrick T. O’Gara, MD, called the decision disappointing and troubling. “Publication of physician payment data without risk adjustment or description of the context will not be helpful to patients and may even lead to inaccurate and misleading conclusions,” he said in a statement.

The society has recommended that physicians have an opportunity to review the data for accuracy before it is released. “The ACC supports price transparency across all aspects of the healthcare system, but we fear this information can be easily misinterpreted without a complete understanding of patient complexity and the cumbersome Medicare billing system.”

Blum argued that public release of payment information will educate patients about operational and reimbursement issues. “It will also allow a more informed debate about the appropriate Medicare payment for particular services.”

The American Medical Association (AMA) also requested that physicians have a chance to review the data for accuracy, which it described as a practical safeguard that is exercised in other data-related CMS programs.

“[A]ny analysis of the data released should note the methodologies to ensure understanding of its limitations,” the AMA wrote in a response to Blum’s letter. “Taking an approach that provides no assurance of accuracy of the data or explanations of its limitations will not allow patients to draw meaningful conclusions about the quality of care.”