Pretty much everyone would agree that when it comes to information about physician practice patterns, outcomes, and costs, the more the public knows, the better. And the staunchest supporters of consumerism are the most ardent advocates of full disclosure of publishing health care provider data. Why just this week Pres. Bush was in Connecticut stumping for his various solutions to the nation’s health care crisis, proclaiming the benefits of information in driving down costs and improving outcomes.
No big news here.
Except that Medicare provider data, the nation’s largest database of provider-specific information, encompassing over a billion claims per year, with information on practice patterns on the vast majority of physicians in the US, and under the direct control of the Federal government (and therefore by Mr. Bush) has not been released to the public. Or anyone else, for that matter.
What’s going on? Well, the Feds claim that the data is private, is covered under a 1979 law prohibiting disclosure of individuals’ data, and therefore cannot be released. This is somewhat confusing, as most physicians practice in professional corporations (that’s the significance of the “P.C.” you see after the name of the doc or medical group) and therefore are not covered by the law.
I’ll admit to a bit of cognitive dissonance here. Are these are the same Feds that can unilaterally release confidential information about national security issues; use Executive Findings to claim exemption from Acts of Congress; the Feds that are of the same party that controls both Houses of Congress and therefore might have some say in what new legislation is passed; the Feds in control of the Attorney General’s office with all its resources, which has demonstrated its willingness to prepare legal documents authorizing all manner of actions?
Given the aggressive position of the Administration on other issues, its willingness to take steps that are bold and controversial on other matters, I’m really surprised that they have been so, well, wimpy on disclosure of Medicare data.
What does this mean for you?
Likely frustration, regardless of your opinion on consumerism in health care.
Apr
12
I seem to remember when I was working for an HMO we had a clause in our provider contracts that stated that we would never publish quality statistics attached to individual providers and that any quality measures we captured on individual providers were for internal use only.
Does Medicare have similar clauses in their contracts? When I heard about this, it made sense to me because it seems kind of shady for Medicare to tell providers their personal quality stats were safe from publication and then all of a sudden to publish it, at least without getting prior approval from each doc. Is that not a valid issue?
I see it as just more evidence of the GWB method of planning. HSAs were introduced with the promise that consumers could shop for care and thereby help control their own costs. In fact, this is one of the selling points of the scheme. Of course, collecting and making the data available is both time consuming and expensive, and I for one don’t anticipate ever seeing enough of it in a timely and searchable fashion to make much of a difference.