Medicare numbers trigger physician anger

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Backlash to the CMS data trove has begun. While yesterday's news capitalized on 9.2 million lines of physician payment data—and statistics like those crunched by the New York Times that showed 2% of doctors received 25% of Medicare payments—Thursday's news is about the doctors themselves.

In short: there is anger. MedPage Today's editor John Geever wrote that a survey participant wrote “IT'S NONE OF YOUR BUSINESS WHAT I'M GETTING FOR MY SERVICES,” caps courtesy of MedPage, and presumably of the unnamed writer who seems attuned to the caps-equals-shouting ethos of the interwebs.

Reactions noted by MedPage, the New York Times and the editor of Policy Prescriptions hit on a bigger issue that was often used as a reason for not posting the data, which is that lay readers will not understand that the numbers are what they are but, at the same time, not what they appear.

As an example, Cedric Dark wrote on the site of health policy group Policy Prescription that the data set shows Medicare paid him $112,134 in 2012. He says while the number is correct, it is not accurate.

“I never once saw a check from Medicare. I never held it, or stashed it in a bank vault, or did one of those Scrooge McDuck swimming through the money pits moments,” he wrote.

Instead, Dark says the money went into a corporate lockbox for the firm that oversees his practice, and that these funds were then used to cover expenses such as corporate salaries as well as those of other healthcare professionals such as hospital and emergency room staff. He wrote that while the data shows money went to him, he ended up walking away with around $181 per Medicare patient, and this was for 60 of the sickest Medicare patients he saw in 2012.

Despite provider angst, HHS was ready, issuing a statement of support yesterday. “Consumers have limited information about how physicians and other healthcare professionals practice medicine...this data will help fill that gap by offering insight into the Medicare portion of a physician's practice,” she said. Sebelius also said the data will give researchers and policymakers “a new window into healthcare spending and physician practice patterns.”

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