HHS Releases Medicare Claims Data; Provider Org. 'Troubled' | Healthcare Informatics Magazine | Health IT | Information Technology Skip to content Skip to navigation

HHS Releases Medicare Claims Data; Provider Org. 'Troubled'

April 9, 2014
by Gabriel Perna
| Reprints

The Department of Health and Human Services (HHS) has released data that reveals Medicare claims payments to providers this week, HHS Secretary Kathleen Sebelius announced.

The data is the third tier of payment information released by the government. Back in May of last year, the Centers for Medicare & Medicaid Services (CMS) publicly released hospital charge information from hospitals across the U.S. It later released more hospital charge information in June.

This latest data shows payment and submitted charges, claims data, for services and procedures provided to Medicare beneficiaries by physicians and other healthcare professionals. The data in this set covers calendar year 2012 and contains 100 percent final-action physician/supplier Part B non-institutional line items for the Medicare fee-for-service population. In particular, it has information for over 880,000 distinct healthcare providers who collectively received $77 billion in Medicare payments in 2012, under the Medicare Part B Fee-For-Service program.

“Currently, consumers have limited information about how physicians and other healthcare professionals practice medicine,” Secretary Sebelius said in a statement. “This data will help fill that gap by offering insight into the Medicare portion of a physician’s practice. The data released today afford researchers, policymakers and the public a new window into health care spending and physician practice patterns.”

The data will help consumers compare 6,000 different types of services and procedures provided, as well as payments received by individual healthcare providers. The consumers can also compare by physician, specialty, location, the types of medical service and procedures delivered, Medicare payment, and submitted charges.

Already, those providers are pushing back, calling the decision to release this data regrettable. “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," Susan Turney, M.D., president and CEO of MGMA, said in a statement.

Read the source article at hhs.gov

Get the latest information on Health IT and attend other valuable sessions at this two-day Summit providing healthcare leaders with educational content, insightful debate and dialogue on the future of healthcare and technology.

Learn More



KLAS Research: Small Hospitals’ Buying Decisions Impacting EMR Market Share

A new KLAS Research report tracks shifts in electronic medical record (EMR) vendor market share among acute care hospitals, and finds that smaller hospitals are seeking technology solutions that meet their needs and limited budgets, and these contracts are making a mark on the EMR market.

Survey: Majority of Providers Predict Success for New Generic Drug Company, Project Rx

Back in January, four health systems, in consultation with the VA, announced a collaboration to develop a new, not-for-profit generic drug company. A survey has found that 90 percent of providers say they would become customers of the new venture.

Personalized Medicine Awareness Low Among U.S. Adults, Survey Finds

Genetics and personalized medicine are not top of mind for the general public in the U.S., according to a recent survey from GenomeWeb and the Personalized Medicine Coalition.

Industry Organizations Praise Senate Passage of VA Mission Act

The U.S. Senate on Wednesday passed, by a vote of 92-5, a major Veterans Affairs (VA) reform bill that includes health IT-related provisions to improve health data exchange between VA healthcare providers and community care providers.

NIH Issues Funding Announcement for All of Us Genomic Research Program

The National Institutes of Health’s (NIH) “All of Us” Research Program has issued a funding announcement for genome centers to generate genotype and whole genome sequence data from participants’ biosamples.

MGMA: Physician Compensation Data Illustrates Nationwide PCP Shortage

Primary care physicians’ compensation rose by more than 10 percent over the past five years, representing an increase which is nearly double that of specialty physicians’ compensation over the same period, according to the Medical Group Management Association (MGMA).