Docs divided on reporting physician-specific Medicare payment data, ACPE survey shows

Physicians have strong opinions on the CMS proposal to publicly report physician-specific Medicare payment data.

The CMS is seeking advice on the best way to publicly report physician-specific Medicare payment data. But if the results of an American College of Physician Executives membership poll are any indication, they may not get clear direction or much cooperation from doctors.

The ACPE e-mailed a survey on the subject to its 11,000 members and, with 593 members responding, 46% said keep the information private, 42% were in favor of publicly reporting the information, and 12% were unsure.

“The lay public is not equipped to handle this type of information,” wrote one respondent. “They do not understand the concept of overhead. They do not know that as an ER doc I collect 30% of what I bill. Imagine the frenzy when the media sums up the payments and reports Dr. X's income from Medicare. The reporting of this info will only lead to more doctor-bashing at a time when smart young people are avoiding entry into medical school like the plague.”

But another respondent said: “It's taxpayer money. They should know. Period. Same goes for where every other tax dollar goes. We live in an information age. We should be able to look up online where our money is going at all times.”

The divided opinions suggest the CMS was wise to ask the physician community for feedback, Dr. Peter Angood, the ACPE's CEO, said in a news release. “No matter what your opinion on this subject may be, there's no doubt the move toward greater transparency in medicine and increased public reporting is here to stay—and we believe it is necessary,” Angood said. “Part of our job as physician leaders is to help ensure that when healthcare data is presented to the public, it is accurate, fair, meaningful and useful.”

The ACPE is still working on its formal comment to the CMS and it will include results of the survey in its remarks.

Comments from some of the respondents were posted on the ACPE's website and included a mix of arguments from both points of view.

Some thought disclosing the information would be beneficial for physicians. “Yes, this information would be useful in facilitating public understanding that it is not 'greedy doctors' that have made healthcare so expensive, but rather, increasing healthcare system overhead, drug and device costs, hospital charges, facility fees, and malpractice fees,” wrote one commenter. “Doctor professional-visit fees from Medicare are a very small part of the overall Medicare payment distribution and the public should have that information.”

Another said fighting to keep the information confidential could backfire. “Medicare and Medicaid dollars are public dollars, taxpayer dollars, and the public should be able to know where its dollars are being spent,” wrote one respondent. “Physicians who don't believe in public transparency puzzle me. It gives an appearance of having something to hide, and thus reduces public trust in our profession. I just can't understand that attitude.”

Still another argument was that generating the reports would only serve to make healthcare more expensive. “To release information only for the sake of releasing information adds no apparent value to anyone, so why do it?” a respondent asked. “Any resources consumed by the process of releasing this information only serve to increase the overall cost of the CMS system, with no 'return on investment.' ”

One commenter wanted to turn the spotlight on high-utilizing Medicare patients. “The other side of the coin: Will CMS then make public how much Medicare money was spent for each individual patient?”

Since 1979, public release of payment information had been prohibited by a court injunction resulting from a Florida Medical Association lawsuit. But, on March 31, the injunction was vacated by U.S. District Judge Marcia Morales Howard in Jacksonville, Fla.

Follow Andis Robeznieks on Twitter: @MHARobeznieks