On Apr 9, the Centers for Medicare in addition to Medicaid Services (CMS) released information on Medicare reimbursements made to private health-care providers inwards 2012. The authorities claims that this was done for the sake of transparency, to trim fraud, in addition to to encourage Americans to seek high-value healthcare. Call me paranoid, but I cannot aid but wonder if in that location mightiness last something to a greater extent than here.
If the goal of releasing these information is genuinely to increase transparency, trim waste, in addition to aid marketplace position forces to amend the efficiency of health-care delivery inwards this country, the information convey to last consummate in addition to accurate. This, however, may non last the case. For example, if Medicare services provided past times a number of health-care professionals are billed nether a unmarried provider, which may last the instance inwards surely programs and/or clinics, that private volition convey these services wrongly attributed to them. In cases where the private physician did really render the services, the information practise non delineate of piece of occupation organization human relationship for differences inwards instance mix, equally some providers really practise run across sicker patients than others. To this end, these physicians may teach reimbursed to a greater degree, but these larger amounts may last only appropriate. Finally, in that location are going to last cases where the information are just just wrong.
It is worth noting that, inwards reviewing the “frequently asked questions” page on CMS's website, I was unable to uncovering a link for physicians to query the accuracy of their data. However, I practise non intend CMS is concerned alongside my opinions on these data.
So, if CMS is non interested inwards the physician's concerns nigh the accuracy or validity of the data, what are they concerned with? Certainly, I believe that in that location is probable some truth to their statements roughly increasing transparency, eliminating waste matter in addition to fraud, in addition to trying to empower patients to choose high-value healthcare. That beingness said, I believe in that location is a hidden agenda here. The Medicare physician reimbursement information were released just weeks after the passage of yet some other temporary legislative piece for the sustained growth charge per unit of measurement (SGR) cuts to providers. The SGR cuts are ever the focus of physician lobbying efforts and, ultimately, politicians are good aware of the negative fallout that would move on if these cuts really went through. By showing the populace just how much Medicare currently pays physicians, it may lessen the political fallout of letting the SGR cuts become through.
In addition, forthwith after the free of the data, the media ran a number of stories showing how some of the highest Medicare billers were likewise some of the largest political donors inwards the United States. Was either of these events a coincidence? I practise non know, but I uncertainty it. I believe that the free of these information past times CMS was an endeavor past times policymakers to sway populace take in against physicians in addition to lessen our political ability inwards Washington. Ultimately, the clinicians must last the ones at the tabular array informing the give-and-take on the effectiveness of treatments in addition to defending our patients' correct to access to these therapies. If policymakers tin give the sack plough the populace against physicians in addition to neutralize the vocalization of organized medicine on Capital Hill, it volition last easier for them brand unilateral changes to the Medicare plan inwards the U.S.A. of America that may lessen costs but may likewise destination upwards pain patients.
I suppose the skilful tidings is that the modern tidings wheel seems to teach shorter in addition to shorter in addition to the media has already moved on from this story. That beingness said, the authorities volition free information on physician payments from pharmaceutical in addition to device companies this fall. I am surely physicians ane time to a greater extent than volition last the focus of negative publicity when this occurs. Ironically, Congress volition last considering some other SGR laid upwards at just the same time. Coincidence? I intend not.
David F. Penson, Department of Urologic Surgery, Vanderbilt Center for Surgical Quality in addition to Outcomes Research, at Vanderbilt University Medical Center, published an article inwards the magazine Urology, called "The Hidden Agenda inwards the Release of the Medicare Physician Reimbursement Data." (Volume 84, Issue 3, Pages 501–502, September 2014.) Excerpts: