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Medicare & Medicaid News

Medicare Records on 880,000 Health Care Providers Now Available for Online Download

Gives consumers unprecedented transparency on the medical services physicians provide and how much they are paid

April 9, 2014 – There is a lot more – a whole lot more, actually – information available today to Medicare beneficiaries who want detailed information on 880,000 distinct health care providers who received $77 billion in Medicare payments in 2012, under the Medicare Part B Fee-For-Service program.

Kathleen Sebelius, Health and Human Services (HHS) Secretary, announced the release of new, privacy-protected data on services and procedures provided to Medicare beneficiaries by physicians and other health care professionals. The new data also show payment and submitted charges, or bills, for those services and procedures by provider.

 

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“Currently, consumers have limited information about how physicians and other health care professionals practice medicine,” said Secretary Sebelius.

The information available is a lot less limited with this release but the volume is far more than all but a few senior citizens will be willing to download and wrestle through on their computer. It is, however, also available to researchers and others who may want to dig through the mountain of detail.

“This data will help fill that gap by offering insight into the Medicare portion of a physician’s practice. The data released today afford researchers, policymakers and the public a new window into health care spending and physician practice patterns,” Sebelius added.

She said this is part of the Obama administration’s work to make our health care system more transparent, affordable, and accountable.

The new data set has information for over 880,000 distinct health care providers who collectively received $77 billion in Medicare payments in 2012, under the Medicare Part B Fee-For-Service program.

With this data, it will be possible to conduct a wide range of analyses that compare 6,000 different types of services and procedures provided, as well as payments received by individual health care providers.

The information also allows comparisons by -
> physician,
> specialty,
> location,
> the types of medical service and procedures delivered,
> Medicare payment, and
> submitted charges.

Physicians and other health care professionals determine what they will charge for services and procedures provided to patients and these “charges” are the amount the physician or health care professional generally bills for the service or procedure.

"Data transparency is a key aspect of transformation of the health care delivery system,” said CMS Administrator Marilyn Tavenner. “While there’s more work ahead, this data release will help beneficiaries and consumers better understand how care is delivered through the Medicare program.”

Last May, CMS released hospital charge data allowing consumers to compare what hospitals charge for common inpatient and outpatient services across the country.

Data are available in two formats:

Tab delimited file format (requires importing into database or statistical software; SAS® read-in language is included in the download ZIP package)

Microsoft Excel format (.xlsx), split by provider last name (note: organizational providers with name starting with a numeric are available in the “YZ” file). 

CMS has also created two summary tables:
1) aggregated information by physician or other supplier and
2) aggregated information by State and HCPCS code.   A detailed methodology document can be found in the Downloads section below which contains important information regarding the limitations of data usage.

>> View the physician dataset

 

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