Medicare Data Dump Ups Transparency

The Centers for Medicare & Medicaid Services released millions of records on Wednesday tracing $77 billion in Medicare payments to physicians, drug testing companies and other practitioners in 2012.

The information was released as part of an overall effort to get more information out to the public about how health care dollars are being spent.  They also will lay the groundwork for changing how Medicare pays specialists.

Reviews of the data can help uncover possible fraud and abuse.  A New York Times story on the release identifies one physician in Florida who was paid $21 million by Medicare in 2012.  However, as this report cautions, a high volume of billing could be an indicator of proficiency – patients are often told to seek out a provider who has experience performing a large number of the same procedure.

While the data sets don’t include any quality metrics, they do enable patients to look at how frequently a practitioner performs a procedure and compare average Medicare payments to various practitioners for the same procedure.  Shining a light on these differences is an important step toward rooting out wasteful spending.

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