NC advocate, doctors’ group, urge caution on using Medicare data

jprice@newsobserver.comApril 9, 2014 

— A North Carolina consumer advocate says the massive federal data dump on Medicare reimbursements to individual doctors and health care providers is a positive move toward better educating the public about health care costs, but he and the president of the state medical society agree consumers should be cautious about drawing early conclusions from what they find in it.

The database, which also includes things like the number of specific tests and procedures performed, is so large and complex that it will take lengthy sifting and analysis before it’s clear how it can be useful, said Adam Searing, health director for the N.C. Justice Center. But more transparency is a good thing when it comes to health care costs, Searing said.

“I don’t think you can immediately generate conclusions from it, but every time we’ve gotten more information like this, it has been one more step toward delivering more effective and efficient health care to consumers,” he said.

Searing said he hoped that once experts begin slicing and dicing the data, it could help with things like identifying doctors who are overtreating patients. If so, that could lead to lower health care premiums for consumers and fewer patients getting procedures they don’t need.

But Searing also noted that people should be cautious about drawing conclusions from the database. For example, trying to compare the number of procedures performed by a specific doctor might be misleading because one of them may rely more on patients with private insurance rather than Medicare.

Dr. Devdutta Sangvai of Duke University Health System, who is the president of the N.C. Medical Society, agreed that releasing the data would be good if it helps reduce waste or abuse.

But Sangvai said that the data could lead consumers to make bad decisions. If they use it to figure out how much their doctor has been reimbursed, for example, that number is of little use without additional information on the quality of the care provided and on the doctor’s business model.

A doctor who specializes in patients who are particularly ill, for example, or who employs a large number of physician assistants will have costs and revenues that look substantially different from those who work differently, he said.

“If we’re looking to make people smarter health care consumers, it’s an incomplete step,” he said. “Maybe down the road, if there is also proper information on quality and on cost structure and it can be merged with this information on revenue, then you may have an effective tool.”

The medical society, which has about 12,500 members, issued a statement that said the data is useful only if its accuracy is assured and consumers are aware of its limitations. The society urged all parts of the health care system, including private payers and hospitals, to make costs transparent so patients could make educated decisions about their care.

2012 Medicare payments to NC doctors

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