Monday, June 1, 2015

Medicare Again Releases One Year's Worth of Provider-Level Data (June, 2015)

In Spring of 2014, Medicare received a year's worth of extremely detailed Part B data, by procedure code AND billing physician or laboratory.   The data dump (some 10 gigabytes' worth) prompted a series of investigative articles and reports from many journalists.  CMS' webpage and press release at the bottom of this article.

On June 1, 2015, Medicare again released some $90B dollars of Part B data, and inpatient and outpatient hospital data, all for CY2013.   So now both CY2012 and CY2013 data are publicly available.

For my blog on last year's May 2014 data release, and additional links, here.
For a separate news release about new May June 2015 initiatives to make Medicare privacy-compliant claims data available to innovators and entrepreneurs, see CMS website here and new report here

Until the release of the data, I hadn't seen any confirmation from Medicare that the data dump would be an annual event (CMS website here).  FCW website, here.  For the New York Times, June 1, 2015, on the second year of released physician data, here.  For WSJ, here.  For an article on Part A data aspects, here.

NYTimes sound bite:
“The list of doctors receiving the highest reimbursements in 2013 included two familiar names from a year earlier, both of whom are facing legal action for their billing practices.  The second-highest earner in 2013 was Dr. Asad Qamar, a Florida cardiologist who received $16 million in 2013, according to an analysis by The New York Times. In January, The Times reported that he is being sued by the federal government as part of two whistle-blower lawsuits that claim he performed unnecessary surgeries.”
On the usability of CMS data, see also Propublica here.   I recently saw a new spin on analysis of Medicare databases, by comparing doctors' drug prescriptions against their payments logged in the Sunshine physician payment database (here).  Message: "Docs do prescribe more in response to payments, but you have to pay them alot!"   Another report, on the Sunshine database rather than the Part B one, found that almost no women physicians were top-dollar speakers (here).

Health Leaders writes, "CMS Data Release Thrills Researchers, not Providers," here.

The CMS webpage, here, and clipped into this blog as follows:

New Medicare data available to increase transparency on hospital and physician utilization

New Medicare data available to increase transparency on hospital and physician utilization
New Medicare data available to increase transparency on hospital and physician utilization

Data serves as a rich resource to clearer look into Parts A and B costs, services, and trends

As part of the Administration’s efforts to promote better care, smarter spending, and healthier people, today CMS is posting the third annual release of the Medicare hospital utilization and payment data (both inpatient and outpatient) and the second annual release of the physician and other supplier utilization and payment data

The announcement was made at the annual Health Datapalooza conference in Washington, DC.

“These data releases will give patients, researchers, and providers continued access to information to transform the health care delivery system,” said acting CMS Administrator Andy Slavitt. “It’s important for consumers, their providers, researchers and other stakeholders to understand the delivery of care and spending under the Medicare program.”

The Medicare hospital utilization and payment data consists of information for 2013 about the average amount a hospital bills for services that may be provided in an inpatient stay or outpatient visit. The hospital data includes payment and utilization information for services that may be provided in connection with the 100 most common Medicare inpatient stays and 30 selected outpatient procedures at over 3,000 hospitals in all 50 states and the District of Columbia. The top 100 inpatient stays represented in the hospital inpatient data are associated with approximately $62 billion in Medicare payments and over 7 million hospital discharges.

The Medicare Part B physician, practitioner, and other supplier utilization and payment data consists of information on services and procedures provided to Medicare beneficiaries by physicians and other healthcare professionals. The data also shows payment and submitted charges, or bills, for those services and procedures by provider. It allows for comparisons by physician, specialty, location, types of medical services and procedures delivered, Medicare payment, and submitted charges. 

The new 2013 dataset has information for over 950,000 distinct health care providers who collectively received $90 billion in Medicare payments. Hospitals, physicians, and other health care providers determine what they will charge for services and procedures provided to patients and these “charges” are the amount the hospital or provider generally bills for the service or procedure, but the amount paid is determined by Medicare’s physician fee schedule or other payment methodologies. CMS protects beneficiaries’ personal information in all its data releases.

“Data transparency facilitates a vibrant health data ecosystem, promotes innovation, and leads to better informed and more engaged health care consumers,” said Niall Brennan, CMS chief data officer and director of the Office of Enterprise and Data Analytics. “CMS will continue to release the hospital and physician data on an annual basis so we can enable smarter decision making about care that is delivered in the health care system.”
The Administration has set measurable goals and a timeline to move Medicare toward paying providers based on the quality, rather than the quantity, of care they give patients. These data releases are part of a wide set of initiatives to achieve better care, smarter spending, and healthier people through our health care system. Open sharing of data securely, timely, and more broadly supports insight and innovation in health care delivery.  

Today’s data release adds to the unprecedented information recently released on Medicare Part D prescription drugs prescribed by physicians and other health care providers.

To view a fact sheet on the CY2013 Medicare Part B physician data, visit:  

To view a fact sheet on the CY2013 hospital charge data, visit: