Targeting health care transparency: Will CMS disclose Medicare payments to medical providers?

6127243966_e9189f1099_zLast week, fourteen groups filed a public comment asking the Centers for Medicare & Medicaid Services (CMS), to disclose Medicare payments to providers. Should the recommendation be implemented, it will add more transparency for health care costs to a system that needs it.

“We urge CMS to uphold its stated commitment to transparency and adopt a policy to promptly disclose, in an open format, payment data, with as much detail as practicable while protecting patient privacy,” recommended the organizations.

The Medicare provider charge data for hospitals showed a significant variation within communities and across the country for the same procedures. Providing more transparency into Medicare payments could help fight fraud and strengthen Medicare itself, argues Gavin Baker, an open government policy analyst at the Center for Effective Government, which signed the public comment.

The public has a fundamental right to know how government spends public funds. Medicare’s tremendous size and impact – $555 billion in expenditures, covering 49 million beneficiaries – make it a prime target for increased transparency. In fact, just the improper payments from Medicare are estimated at a whopping $44 billion – which is more than the entire budget for the Justice Department.

Releasing payment data would allow members of the public, including journalists and watchdogs, to help detect fraud or improper payments. That increased scrutiny could deter fraudsters– as happened with spending under the 2009 Recovery Act. This in turn could strengthen Medicare and help ensure its ability to continue playing its vital role in securing health care for America’s seniors.

The signatories to the public comment are a roll call of good government advocates, journalism organizations, think tanks and media outlets in the United States, demonstrating widespread interest in the data and a hint of the organizations that stand ready to make use of it.

Such a data release has a recent precedent: in May, the  United States Department of Health and Human Services released open data that compares the billing for the 100 most common treatments and procedures performed at more than 3000 hospital in the U.S. No patient privacy violations related to this release have been reported or demonstrated to date.

Should CMS choose to publish Medicare payments to providers, it would make 2013 a watershed year for increased data-driven transparency into health care costs.

Image Credit: Images of Money

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