Updates to Increase Transparency of the Medicare Program by CMS
The Centers for Medicare & Medicare Services (CMS) is releasing updated data to increase transparency in the Medicare program. CMS has posting the third annual release of the Physician and Other Supplier Utilization and Payment public use data. In addition to this CMS is also announcing the availability of more timely data for researchers.
The Physician and Other Supplier Utilization and Payment data contains summarized information on Part B services and procedures provided to Medicare beneficiaries by physicians and other healthcare professionals. The information includes payment and submitted charges, or bills, for services and procedures provided by each physician or supplier. It helps in comparisons by physician, specialty, location, types of medical services and procedures delivered, Medicare payment, and submitted charges.
The updated 2014 dataset has information for over 986,000 distinct health care providers (up from 950,000 in 2013) who collectively received $91 billion in Medicare payments (compared to $90 billion in 2013). The Medicare standardized payment amount, which removes geographic differences in payment rates for individual services, such as those that account for local wages or input prices, and makes Medicare payments across geographic areas comparable, is new in the 2014 data. CMS protects beneficiaries? personal information in all its data releases.
CMS is also making more timely extracts of Medicare claims data available to researchers who access this data via Limited Data Sets (LDS). Historically, researchers have only been able to request annual extracts of Medicare data under the Limited Data Set (LDS) request process. With the changes announced, researchers will be able to request updates to their Limited Data Set (LDS) claims files as frequently as quarterly, making it easier to do the important research that will continue to result in better quality and lower costs in the health care system.
Medicare increasingly pays providers based on the quality, rather than the quantity, of care they give patients, therefore the release of timely, privacy-protected data is especially important. These initiatives contribute to a wide set of CMS activities focused on achieving better care, smarter spending, and healthier people throughout the health care system.