Following the Centers for Medicare & Medicaid Services’ (CMS) release of physician Medicare claims data—called a “treasure trove” by the media, despite its considerable limitations—the AMA is urging CMS to develop and refine a more selective data set that will help patients and physicians make more informed care choices.
“The lesson to be learned from the release of raw 2012 physician-specific Medicare claims information is that transparency is twofold,” the AMA said in a letter to CMS. “It requires not only access to data but understanding the scope, exclusions and limitations of the information. Without this context, conclusions and analyses are likely to be wrong.”
An AMA code-by-code comparison of the data file to another 2012 data file found that codes for nearly 40 percent of physician services were missing. “Untrained observers … are using the data file to make flawed regional, specialty or other comparisons that CMS should do more to discourage,” the letter said.
The AMA pressed CMS to remedy the data set release by putting resources into developing a data set that would be useful for physicians and patients, achieving the agency’s goal of providing transparency to patients. The data set released in April does not include crucial metrics that should be part of information intended for patients, including quality, outcomes, and a complete picture of the physician’s practice.
Further, the AMA told CMS that adding data from prior years before assessing the full impact of the initial data release was putting the cart before the horse. “To publish more years of data … is a diversion from the real work that is needed,” the letter said.
The AMA also urged CMS to allow physicians to correct and explain their data. The agency has argued that there is no need to let physicians correct wrong information because the information came from physicians themselves.
“That answer is simply unacceptable,” the AMA said in the letter, adding that not all the errors in the data base were made by physicians and that unintentional administrative errors by physicians do not justify the deliberate release of inaccurate information that misleads patients.
The letter pointed out CMS’ struggles with ensuring accurate information in its own data sets, citing the Physician Compare website, which needed a complete overhaul to correct inaccurate search functions and other problems.
Finally, the AMA pushed CMS to conspicuously display and clearly communicate any limitations with the data. The agency’s patient tool that required website visitors to view a list of limitations was a step in the right direction, but not enough. More context and explanation is needed, the letter said.
“CMS should encourage the development of complete, accurate and timely data that could support a more value-driven health system,” the letter said. “CMS’ attention, however, has been diverted away from these more meaningful efforts to pursue information that fails to convey useful and accurate data.”
Visit the AMA’s resource page to view information about the data release, including a patient handout that provides context.