Medicare Data Release Worries Medicine

The potential release of Medicare physician claims data to the public "can have unintentional, adverse consequences for patients, providers, and the health care system" if not done correctly, the Texas Medical Association, the American Medical Association, and other state medical societies warned federal officials in August.

The Centers for Medicare & Medicaid Services (CMS) asked for public comments on whether and how to modify its current data release policy after a Florida court lifted an injunction that prohibited the release. Groups can now file Freedom of Information Act requests for physician payment data, and CMS will decide to release the data on a case-by-case basis.

"For any data release program, safeguards must be in place to ensure that neither false nor misleading conclusions are derived from this information," organized medicine said in the letter to CMS. 

The medical societies urged CMS to adopt policies that:

  • Focus on release efforts that seek to improve health care quality;
  • Ensure accuracy of the data by educating those accessing the information and allowing physicians to review and correct any errors; and
  • Follow existing safeguards, including appropriate risk-adjustment and attribution methods, for any public reports that use the information.

"If used correctly, this data can provide accurate and meaningful information to patients, physicians, and other stakeholders that can improve quality at the point of care," the letter said. "We therefore support the appropriate use of Medicare claims data to inform and improve our health care system."

They urged CMS to work with physicians to develop policies to promote "the reliable and effective use of this information. We urge CMS to carefully consider how use of this data may change over time, and the role it may play in an evolving Medicare system. Our goal is to promote efforts focused on improving the quality of patient care while safeguarding against potential abuses that could negatively impact health care outcomes or diminish the privacy of Medicare physicians and patients."   

The letter also expressed concerns about a threat to patient and physician privacy from release of the information and misinterpretation of the data.  

 Action, Sept. 4, 2013