CMS Database Shows Medicare Payments to Doctors, Others in 2012

The Wall Street Journal today has published a searchable database of information made public by the Centers for Medicare and Medicaid Services. The list shows total Medicare payments to doctors and other health care providers across the country, including Arkansas, in 2012.

This is the first time such information has been released this way, and the Obama administration is casting it as part its work "to make our health care system more transparent, affordable, and accountable." Doctors and other health care providers, however, aren't so happy about the data's release.

The American Medical Association, which has fought to keep the records under wraps, cautions about taking the data out of context:

"What we don't want to happen here is that patients be misinformed by raw data," said Ardis Dee Hoven, president of the AMA. "At the end of the day, what we need in this country is data that shows value, and this data isn't going to show value."

Meanwhile, the Medical Group Management Association put out a statement this morning that said while it supports "constructive release" of cost and quality data, it finds CMS' move to release physician claims data "problematic."

MGMA is troubled about the potential for unintended consequences as a result of the release of this type of data and the effect it may have on Medicare beneficiaries. This release could result in patients making decisions about their care based on faulty assumptions about physicians. Claims data are not a proxy for quality, especially when provided in isolation, from a single payer. 
MGMA is also concerned about the impact on physician privacy, as releasing physician’s personal financial data and National Provider Identifier (NPI) information could make providers susceptible to fraud. Physicians should have had the opportunity to review the data before it was made publicly available in order to modify or appeal any inaccuracies.

Many of those criticisms are echoed by other groups commenting for The Wall Street Journal's story accompanying the searchable database.

The story also notes that some information is missing from the CMS data, including procedures performed on fewer than 10 of a provider's patients and figures on durable medical equipment. That puts a $22 billion hole in the $99 billion spending total for 2012, the report says.

In Arkansas, the CMS data shows that the top three providers, ranked by total payments in 2012, were Little Rock Ambulance Authority ($7.3 million), Dr. Kamal Patel of Little Rock Hematology Oncology ($7.3 million) and CARTI ($6.3 million), all of Little Rock.

At least 200 providers are listed for Arkansas. Four hematology/oncology providers were listed in the top 10.

The list also shows the types of procedures the providers performed, the number of those procedures and the average payment for those procedures.

You can search the Journal's database here, and you can download all the source Excel files directly from CMS here.