Physician Groups Find Fault With Medicare Payment Data Release

Biggest complaint is a lack of context with which to interpret the data

THURSDAY, April 24, 2014 (HealthDay News) -- Physician groups cite major problems associated with the release of Medicare payment data, according to an article published April 16 in Medical Economics.

According the author of the article, Alison Ritchie, physician groups say that when the Centers for Medicare and Medicaid Services (CMS) published the 2012 Medicare payment information ($77 billion payments for 880,000 physicians identified by name) they failed to provide context for the data.

Ritchie notes that the American Medical Association (AMA) has outlined the following problems with the data: (1) physicians were not provided the opportunity to review or correct the data prior to publication; (2) quality measurements were not included; (3) it's not clear who provided the services, as midlevel providers may bill under the national provider identifier; (4) the data reflects fixed payment prices, not what was charged; (5) private insurance and Medicaid patients were not included and patient demographics were not provided; (6) location of service provision was not provided; (7) specialty descriptions and practice types were not provided; and (8) geographical differences in billing were not taken into account.

"The information released by CMS, will not allow patients or payers to draw meaningful conclusions about the value or quality or care," said Ardis Dee Hoven, M.D., president of the AMA, according to the Medical Economics article.

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