Making Sense of the Medicare Physician Payment Data Release: Uses, Limitations, and Potential

Abstract

In April 2014, the Centers for Medicare and Medicaid Services released a data file containing information on Medicare payments made to physicians and other providers. Though an important achievement in promoting greater health system transparency, limitations in the data have hindered key users, including consumers, payers, and providers, from discerning meaningful information from the file. This brief outlines the significance of the data release, the limitations of the dataset, the current uses of the information, and proposals for rendering the file more meaningful for public use.

Disparities in delivery of ophthalmic care; An exploration of public Medicare data

“…On April 9, 2014, the Centers for Medicare & Medicaid Services (CMS) released the Medicare Provider Utilization and Payment Data with information on services and procedures provided to all Medicare beneficiaries. This public data covers the 2012 health expenditures on the Medicare population for 100% of fee-for-services, which includes nearly 10 million records related to a total of $77 billion in Medicare payments [ 10 , 11 ]. Combining Medicare claims data with the US Census information can illustrate the nationwide demand and availability of cataract care delivery.…”

Regional Variations of Medicare Physician Payments for Hand Surgery Procedures in the United States

“…14 Release of Medicare-related payment data was previously not available; therefore, the recent release of this information has been controversial, raising questions regarding the variation in charges and payments for physicians, hospitals, and health care organizations. 16 Accurate interpretation of this large data set is important for orthopedic surgeons to understand what accounts for the variation in cost and payments for the common procedures they perform. As health care spending continues to increase and Medicare and Medicaid access increases, further pressure to control costs will likely occur particularly for high-volume surgical procedures in orthopedic surgery.…”