Medicare Posts 2013 Hospital, Physician Payment Data Online

June 1, 2015 in News

On Monday, CMS publicly released new online data that reveal hospitals’ Medicare charges and payments, as well as what doctors billed, in 2013, Modern Healthcare reports (Herman, Modern Healthcare, 6/1).

The data, released at the Health Datapalooza conference in Washington, D.C., continues CMS’ commitment to transparency, officials said (CMS release, 6/1). The three data sets released by CMS encompass more than 3,000 hospitals and more than $150 billion in total payments

Hospital Data Details

The Medicare hospital utilization and payment data include information related to the 100 most common Medicare inpatient stays, which represent approximately $62 billion in Medicare payments and more than seven million hospital discharges. The hospital data set also includes information on 30 selected outpatient procedures (Modern Healthcare, 6/1).

The data show that major joint replacement remained the most frequent discharge in the nation, with 446,148 total discharges.

CMS said that hospital charges have increased at a “modest rate.” For example,┬ámajor joint replacement charges have grown from $50,116 in 2011 to $54,239 in 2013 (CMS fact sheet, 6/1).

Physician Data Details

Meanwhile, the new Medicare Part B data include payments to more than 950,000 distinct health care providers who collectively received $90 billion in Medicare payments (CMS release, 6/1).

The data show that physicians on average were reimbursed $74,000 by Medicare in 2013, Bloomberg reports. However, at least 3,900 individual physicians were paid at least $1 million, while five doctors were paid more than $10 million (Tracer/Chen, Bloomberg, 6/1).

Acting CMS Administrator Andy Slavitt said, “These data releases will give patients, researchers and providers continued access to information to transform the health care delivery system.” He added, “It’s important for consumers, their providers, researchers and other stakeholders to understand the delivery of care and spending under the Medicare program” (Walsh, Clinical Innovation Technology, 6/1).

AMA Reaction

In a release, American Medical Association President Robert Wah said his organization is concerned that the 2013 data have “significant shortcomings,” such as a lack of:

  • “Actionable information on the quality of care”; and
  • Appropriate “context to prevent … inaccuracies, misinterpretations and false assertions.”

Wah wrote, “We continue to urge CMS to improve upon its data releases so that patients and physicians can actually use the information to better work together to improve quality, improve health outcomes and reduce costs” (AMA release, 6/1).

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