Apr 02, 2014

Next steps in Medicare data transparency

Jonathan Blum
Principal Deputy Administrator, Centers for Medicare & Medicaid Services

In letters to the American Medical Association and Florida Medical Association http://downloads.cms.gov/files/Madara_Final_Signed.pdf, the Centers for Medicare & Medicaid Services (CMS) announced our intent today to take another major step forward in making our health care system more transparent and accountable. We plan to provide the public unprecedented access to information about the number and type of health care services that individual physicians and certain other health care professionals delivered in 2012, and the amount Medicare paid them for those services, beginning not earlier than April 9. Providing consumers with this information will help them make more informed choices about the care they receive.

The new data provides a better picture of how physicians practice in the Medicare program, and the payments they receive. This data contains information on more than 880,000 health care professionals in all 50 states who collectively received $77 billion in payments in 2012 for services delivered to beneficiaries under the Medicare Part B Fee-For-Service program. With this data, it will be possible to conduct a wide range of analyses that compare 6,000 different types of services and procedures provided, as well as payments received by individual health care providers.

CMS takes beneficiary privacy very seriously, and does not publicly release any personally-identifiable information about beneficiaries. To further protect beneficiary identities and safeguard this information in this new data, CMS will redact all data in cases where it includes fewer than 11 beneficiaries.

Data like these can shine a light on how care is delivered in the Medicare program. They can help consumers compare the services provided and payments received by individual health care providers. Businesses and consumers alike can use these data to drive decision-making and reward quality, cost-effective care. We look forward to describing how this information can inform consumers and health care providers when we release this data in the near future.

The new data initiative builds on the work we did last year to release information on charges submitted to Medicare by individual hospitals (http://www.cms.gov/Research-Statistics-Data-and-Systems/Statistics-Trends-and-Reports/Medicare-Provider-Charge-Data/Inpatient.html and http://www.cms.gov/Research-Statistics-Data-and-Systems/Statistics-Trends-and-Reports/Medicare-Provider-Charge-Data/Outpatient.html).

The initiative announced today, as well as the previously released hospital data, build on the powerful tools we have from the Affordable Care Act to advance transparency in the health care system. For example, Medicare is beginning to pay providers based on the quality they deliver rather than just the quantity of services they furnish by implementing new programs such as value-based purchasing and readmissions reductions. In addition, last year, CMS made approximately $87 million available to states to enhance their rate review programs and further health care pricing transparency.

While we have made significant progress in making the health care system more open and accountable, we look forward to making this important, new information available so that consumers, Medicare and other payers can get the best value for their health care dollar.