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Medicare to Release Billing Data for 880K Doctors

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  • Medicare to Release Billing Data for 880K Doctors

    What is this going to do? How is seeing how many procedures you have billed for going to show who gets the best results? This seems like it would hurt young doctors whose numbers aren't built up yet. What am I missing? I don't see the point?

    Patients may soon get an unprecedented look at how their doctor compares to other physicians, after Medicare announced Wednesday it plans to publicly post billing data for more than 880,000 practitioners.Considered the mother lode of information on doctors, the Medicare claims database has been off-limits to the public for decades, blocked in the courts by physician groups. The American Medical Association has argued that its release would amount to an invasion of doctors' privacy. Consumer groups, insurers, employers and the news media have sought the information to help them evaluate clinicians.
    Wednesday, the Obama administration came down on the side of disclosure.
    Medicare Deputy Administrator Jonathan Blum said in a letter to the American Medical Association that the agency intends to post the data publicly as early as next week, April 9.
    "Over the past 30 years, the landscape has changed with respect to physician information that is available to the public," wrote Blum. "As a result, the health care system is changing from a system dominated by dearth of usable, actionable information to one where care coordination and dramatically enhanced data availability ... will power greater innovation, higher quality, increased productivity and lower costs."
    The AMA is concerned that the release of information planned by Medicare will mislead people into making "inappropriate and potentially harmful treatment decisions and will result in unwarranted bias against physicians that can destroy careers," the association's president, Dr. Ardis Dee Hoven, said in a statement.
    The AMA recommends that physicians be allowed to review and correct their information before Medicare releases it, Hoven said. "Taking an approach that provides no assurances of accuracy of the data or explanations of its limitations will not allow patients to draw meaningful conclusions about the quality of care," she said.
    Doctor ratings have often been based on the opinions of other doctors. The Medicare billing files would usher in a new era of hard data. Doctors could be tracked and evaluated the same way that baseball players are — using statistics.
    Supporters of disclosure say the information will help lead consumers to doctors who have the greatest expertise and who get the best results. For example, if you're about to undergo heart bypass, you could find out how many operations your surgeon did last year. Research shows that for many procedures, patients are better off going to a surgeon who performs them frequently.
    The data could also be used to spot fraud, such as doctors billing for seeing more patients in a day than they would reasonably be expected to care for.
    But doctors worry that some physicians could be unfairly singled out. They point to the example of clinicians practicing in economically depressed areas, seeing patients who can't afford medication copays or who don't follow through with basic self-care. The numbers may not look so good for those doctors, but it may not be because of anything they did wrong.
    Officials say the files contain data on every test and procedure billed for in 2012 by individual doctors in all 50 states, who together received $77 billion that year through Medicare's Part B coverage for outpatient services. It will amount to close to 10 million lines of data. Doctors who saw fewer than 11 Medicare beneficiaries will be excluded.
    Although individual patient information will remain off-limits, the files will identify physicians by name.
    The Obama administration has been inching toward fuller disclosure for months, driven in part by provisions of the new health care law, but also by legal pressure from The Wall Street Journal and other media organizations.
    "Release of physician-identifiable payment information will serve as significant public interest by increasing transparency of Medicare payments to physicians ... and shed light on Medicare fraud, waste and abuse," wrote Blum.
    Wife to NSG out of training, mom to 2, 10 & 8, and a beagle with wings.

  • #2
    Patent bullshit.
    Heidi, PA-S1 - wife to an orthopaedic surgeon, mom to Ryan, 17, and Alexia, 11.


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    • #3
      one more reason to despise CMS
      Kris

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      • #4
        It's all part of the push to lower physician compensation, imo. It's being put out their so people can look and say, "look how much he billed", "wait, that was for only a 20 minute procedure", "doctors are over paid". Disclosure my ass, it's simply part of the push to say doctor salaries are what is causing the sharp rise in healthcare. None of this is done by accident. Nothing good can come from releasing data that cannot be understood by the average person and will just be misinterpreted by the media.
        Tara
        Married 20 years to MD/PhD in year 3 of MFM fellowship. SAHM to five wonderful children (#6 due in August), a sweet GSD named Bella, a black lab named Toby, and 1 guinea pig.

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        • #5
          What Tara said.
          ~shacked up with an ob/gyn~

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          • #6
            Yup. I hate medicine. I further hate insurance companies. May they all suck it.
            Heidi, PA-S1 - wife to an orthopaedic surgeon, mom to Ryan, 17, and Alexia, 11.


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            • #7
              And DH just made the point that he hasn't entered the codes, how does he know they're correct? This should be VERY interesting.
              Wife to NSG out of training, mom to 2, 10 & 8, and a beagle with wings.

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              • #8
                DH also thinks that the database will be so big that only academics and the media with huge mainframe computers will be able to access/analyze it which means it will be even more crap!
                Wife to NSG out of training, mom to 2, 10 & 8, and a beagle with wings.

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                • #9
                  Dh doesn't operate on Medicare patients.... So he won't even show up? Someone will look him up and think he's an incompetent idiot?

                  The thing to watch is the "looking out for fraud" bit. This burned my dad. L&I said he billed too much and was too productive. Then they audited him to death and eventually a govt official took away his ability to treat L&I patients. Some bureaucrat asshole with an accounting degree smeared my dad's name in the medical community. My dad was president of the EM docs group of WA state at one point. What a joke.

                  So...

                  Nothing good comes from any of this and I'm sick to death of politicians and obamacare. Insurers have always been the devil but before Obama they didn't have this kind of power. Why does Obama hate doctors? Why does he want the government to control everything? Ugh what a disaster.
                  Peggy

                  Aloha from paradise! And the other side of training!

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                  • #10
                    Well, there has also been a huge push to downcode everything as well. People want to be seen for their complex, time-consuming issues but no one wants to foot the bill. Ultimately, my guess is there will be more downcoding and longer waits for medicare patients.
                    ~Mom of 5, married to an ID doc
                    ~A Rolling Stone Gathers No Moss

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                    • #11
                      Originally posted by SuzySunshine View Post
                      And DH just made the point that he hasn't entered the codes, how does he know they're correct? This should be VERY interesting.
                      My husband checks EVERY single code! He brings home piles of stuff to do this every week. He doesn't want to be charged with fraud.

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                      • #12
                        DH's issue isn't fraud its an issue of under-coding. He had a very skilled coder who left and so for several months he had a general surgery coder and it was obvious she was under-coding some of his most complicated cases. Luckily their office manager caught it and was reviewing them not only for Medicare/Insurance but for his RVUs. He now has an experienced neurosrugery coder again so hopefully its not an issue. If this data is from 2012 he would have only been in practice for 8 months that year so it will be interesting to see if I can get to it.
                        Wife to NSG out of training, mom to 2, 10 & 8, and a beagle with wings.

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                        • #13
                          The database is out: http://www.washingtonpost.com/wp-srv...abase/?hpid=z1

                          I searched DH, he is not listed though he would have started practicing in 2012. One of his partners is but at his old practice address, not the current practice...

                          And here is the story that goes with it
                          http://www.washingtonpost.com/busine...56a_story.html
                          Wife to NSG out of training, mom to 2, 10 & 8, and a beagle with wings.

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                          • #14
                            DH is on there. Makes his pay look small. Good. Fuckers.
                            Heidi, PA-S1 - wife to an orthopaedic surgeon, mom to Ryan, 17, and Alexia, 11.


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                            • #15
                              yep, I was wrong mine is to - $10k, really?
                              Wife to NSG out of training, mom to 2, 10 & 8, and a beagle with wings.

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