Medicare doctor payment data reveals much about health system

Apr 15 2014

The trove of data has the potential to reveal faults in drug pricing, potential fraud and could help regulators and consumers track medical spending -- but could take years to sort out.

The Washington Post: These Maps Tell You Everything That's Wrong With Our Drug Pricing System
The kind of health care you get and how much it costs depends a lot on where you live. Take, for example, the way that doctors across the U.S. treat a chronic eye disease, known as wet age-related macular degeneration, that among older people had long been a leading cause of blindness. There is no evidence that the disease varies from place to place. But as recent Medicare data show, the way that doctors' treat it does, and those choices have huge effects on the U.S. and personal budgets (Rich and Whoriskey, 4/11).

Reuters:  Lawyers Start Mining The Medicare Data For Clues To Fraud
Within hours of the U.S. government's unprecedented release last week of a trove of Medicare billing data, a small fraternity of lawyers who specialize in representing whistleblowers in health care fraud cases began to mobilize. These lawyers earn their living bringing cases on behalf of employees at drug companies and health care providers who believe their bosses or colleagues may be cheating the federal Medicare system by bribing doctors to prescribe certain drugs, for example, or inflating bills (Baynes, 4/14).

Bloomberg News:  Medicare Pay List May Open Door To More Data
Doctors denounced the accuracy and value of data listing $77 billion in Medicare payments to 880,000 medical providers, while consumer and industry groups said it could make the health care system more cost-effective. The divergent views of Medicare's first-ever release of U.S. payments to physicians suggested the impact may take years to play out. U.S. officials, meanwhile, said they may follow Wednesday's report on 2012 data by providing the same information from earlier years, a move that would help regulators and consumers trace changes in health care over time (Wayne and Chen, 4/11).