By Jim Knaub
On April 9, the Centers for Medicare & Medicaid Services (CMS) released data sets reporting what each physician and other providers were paid as part of the Medicare program. You can download the large data files from the CMS website, and with some effort, analyze them with database or spreadsheet software.
On the same day, The New York Times published an article about the physician data accompanied by a Web tool that allows users to quickly look up how much any physician was paid by Medicare Part B. Within a few minutes, I had found the Medicare reimbursement of my primary care physician, my dermatologist, and the surgeon who operated on my foot. The data files show what procedures each physician performed and how many by procedure code. They also include a selection of charge data, including gross charges, Medicare allowable charges, and average reimbursements. It’s interesting stuff to anyone in this business.
Then I looked up the Medicare reimbursement for some radiologists whom I know. On one level, I felt a little dirty seeing the amounts these men and women received from Medicare, but I also value the idea of transparency in how tax dollars are spent. Admittedly, I’m not sure how this data release meshes with transparency.
Perhaps more importantly, I understand that the information tells me only so much. Reimbursement doesn’t equal take-home pay, but not everyone gets that. When I looked at the CMS data, it also became clear that many people who read news reports about the data wouldn’t understand what those numbers really mean. The fact that Radiologist A received $220,000 from Medicare, Radiologist B earned $100,000, and Radiologist C collected $60,000 doesn’t mean much by itself. For example, the numbers say nothing about how many shifts a radiologist works per year. You don’t know whether a radiologist has a large or small percentage of Medicare enrollees in his or her patient mix. Even within a specialty, different practices carry vastly different amounts of overhead expenses.
The data set offers me more insight into what physicians do than it does about their take-home pay. But news reports of huge numbers—multiple millions for a small segment of physicians—will undoubtedly be interpreted by many as all doctors make huge sums from Medicare.
The day after the data was released, the CNN.com home page boasted the story teaser “Doctors make millions off of Medicare.” While that tease technically isn’t false, it’s a misleading generalization. The perception of “rich doctors” is something physicians have faced and dealt with for a long time.
At the same time, I understand the importance of transparency in both health care and how our tax dollars are spent. The notable lack of transparency has been a significant driver in health care costs, but the truth is, that’s a long-standing, complex problem. This data release moves in the direction of greater transparency, but not much. It will take a lot more than revealing what physicians receive in Medicare to meaningfully address this problem.
— Jim Knaub is editor of Radiology Today.