Medicare Payment Data Release Concerns Some Otolaryngologists

CMS, in the statement issued by Maisler, said the agency provides more than just data on quantity of payments. It noted that CMS has just started releasing quality data on physicians through the Physician Compare website (medicare.gov/physiciancompare). The agency also pointed to the Qualified Entity program, in which approved organizations have access to Medicare data in order to combine it with other claims data, allowing them to develop performance reports on individual providers. “While utilization data is a valuable resource for stakeholders, quality information is also important,” the CMS statement said.

In addition to concerns that the information might be misleading—even posing a potential disservice to patients—physician groups also say the data release might represent a missed opportunity. “Due to its non-user-friendly format, lack of contextual information, and serious limitations, the data are not helpful for patients or physicians,” Dr. Wah said. “It would have been a better use of time and resources for CMS to provide timely, actionable data that would have a positive impact on care delivery in this country by helping patients and physicians make healthcare decisions that lead to high quality, cost-effective care.”

Dr. Setzen has a similar opinion. His concerns about the data release are “not to say that transparency, accuracy, and this kind of data should not be sought or available. I mean, that’s important. And if the context is appropriate and if the physician has potentially had an opportunity to review the data, comment, and correct it, when necessary, prior to the release, I think that would give a little bit of additional comfort to the physician and larger medical community.”

But even ascertaining the accuracy and validity of the data would be a sizable job, Dr. Setzen said, involving specialists who might need significant time and resources to properly review everything. With no avenue for data correction currently available, it might not be worthwhile, he said. “I think it would be a significant burden that would [require] significant resources to do that, in addition to complying with a myriad of other regulatory mandates like meaningful use and ICD-10 implementation,” he added. “One has to be able to justify that.”