CMS Shares $62B in Medicare Payment Data, Doctor Utilization
By - The Centers for Medicare & Medicaid Services (CMS) announced the third annual release of its Medicare hospital utilization and payment data at this week's annual Health Datapalooza conference in Washington, DC. CMS confirms this effort to enhance data transparency is intended to promote intelligently executed spending.
The release presents the average amount a hospital bills for services provided in either an inpatient stay or outpatient visit within 2013. The hospital data made available includes payment and utilization information for services possibly provided in association with the 100 most common Medicare inpatient stays – representing $62 billion in Medicare payments and 7 million hospital discharges – and 30 selected outpatient procedures at 3,000 hospitals across all 50 states.
“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,” CMS maintains. “Open sharing of data securely, timely, and more broadly supports insight and innovation in health care delivery.”
The greater implications of transparency in Medicare Part B spending represent a substantial focus of CMS’ data. In 2013, healthcare providers received nearly $90 billion in Medicare payments.
Data transparency is key to the health industry’s advancement, confirms CMS. “Data transparency facilitates a vibrant health data ecosystem, promotes innovation, and leads to better informed and more engaged health care consumers,” explains 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,” Brennan adds.
According to CMS’ hospital-specific inpatient charge data, the average Medicare payments for 2013 ranged sizably from approximately $1,200 to $98,000. Total discharges per hospital – the number of beneficiaries released from an inpatient hospital after receiving care – similarly ranged substantially from 11 to nearly 3,700. Hospitals determine the chargeable amounts for items and services, CMS confirms. Comparisons can be made between the amount an individual hospital charges and larger markets regarding inpatient services, CMS adds.
Such data promotes the advancement of knowledge across the healthcare spectrum, CMS confirms. “These data releases will give patients, researchers, and providers continued access to information to transform the health care delivery system,” states Andy Slavitt, Acting CMS Administrator. “It’s important for consumers, their providers, researchers and other stakeholders to understand the delivery of care and spending under the Medicare program,” he adds.
American Medical Association confirms CMS’ data flaws
Although the American Medical Association (AMA) confirms its enduring commitment to transparency and support for data dissemination to advance care quality, the organization has maintained CMS’ Medicare claims data contains numerous inaccuracies due to weak content and lack of physician authorization that may actually promote widespread confusion.
CMS has made an imperative improvement to its physician claims data release through the separation of Part B drugs from payment for physician services, confirms a June statement from Robert M. Wah, MD, AMA President. Such initiatives from CMS eradicate the incorrect notion that drug reimbursement and physician income are intertwined, Wah maintains, but there are still concerns about the utility of the data.
"Specifically, the data released today do not provide actionable information on the quality of care that patients and physicians can use to make any meaningful conclusions," says Wah. "The data also do not provide enough context to prevent the types of inaccuracies, misinterpretations and false assertions that occurred the last time the administration released Medicare Part B claims data."
Wah advises CMS make continuous improvements to its data releases. Such actions will help ensure both beneficiaries and physicians can successfully and efficiently use CMS' information to improve quality, advance health outcomes, and actively decrease healthcare costs, Wah confirms.
In light of the value-based movement, it is hopeful easily accessible information will increase collective professional awareness and in turn promote actionable improvement within the healthcare industry.
