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CMS Releases Medicare Payment and Utilization Data

June 1, 2015
by Gabriel Perna
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The Centers for Medicare and Medicaid Services released a trove of Medicare data this week at the annual Health Datapalooza conference in Washington, D.C. in what has become a yearly ritual for the agency.

This was the third straight year CMS dumped Medicare data at the Health Datapalooza conference in Washington and the second straight year that it included physician and supplier utilization and payment data. The data dump is part of CMS’ move towards transparency, making Medicare data available for public consumption.

“These data releases will give patients, researchers, and providers continued access to information to transform the health care delivery system,” acting CMS Administrator Andy Slavitt said in a statement. “It’s important for consumers, their providers, researchers and other stakeholders to understand the delivery of care and spending under the Medicare program.”

This particular dataset is on the 100 most common Medicare inpatient stays and 30 selected outpatient procedures at over 3,000 hospitals in all 50 states and the District of Columbia. It includes the average amount of hospital bills in 2013 for those services. CMS also included charge data in this release. Specifically, it released Medicare Part B physician, practitioner, and supplier utilization and payment data on 950,000 distinct healthcare providers who collectively received $90 billion in Medicare payments in 2013.

The data shows that major joint replacement or reattachment and severe sepsis treatment were among the highest charged procedures in hospitals in 2013. The two combined for more than a total allowed cost of more than $12 billion alone. The Part B data showed that Oncology, Ophthalmology, and Rheumatology were among the top specialties in terms of cost per provider.

In the past, CMS has multiple interactive dashboards, including one that uses the spending data to calculate how much Medicare beneficiaries spend on specific chronic conditions. They’ve also pushed forward on their compare websites, recently introducing a star-rating system based on how hospitals rate on several quality measures.



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