CMS Releases New Round of Medicare Data

This is the third year that CMS has released Medicare payment data, and this year the agency added information on prescription drugs.

The Centers for Medicare and Medicaid Services (CMS) today released its third annual round of data on what the Medicare system paid and how beneficiaries used hospitals, along with the second year’s worth of information on what physicians and suppliers are being paid from the program.

For the first time, this year’s data release also includes information on Medicare Part D prescription drugs that were prescribed by physicians and healthcare providers.

“These data releases will give patients, researchers, and providers continued access to information to transform the health care delivery system,” said acting CMS Administrator Andy Slavitt. “It’s important for consumers, their providers, researchers and other stakeholders to understand the delivery of care and spending under the Medicare program.”

Data releases are part of CMS’ movement toward transparency, which the agency believes over time will lead to more informed decision-making as consumers assume more of the cost of their own care. Releases of data tend to show disparities in what is paid for the same hospital service within a region, and may reveal cases in which a provider is billing an unusually high amount to Medicare.

The data released today includes what hospitals charged, on average, in 2013 for services that were provided during an inpatient or outpatient stay. According to a statement from CMS, the hospital data includes “payment and utilization information for services that may be provided in connection with the 100 most common Medicare inpatient stays and 30 selected outpatient procedures at over 3000 hospitals in all 50 states and the District of Columbia.”

The most common stays were culled from approximately $62 billion in Medicare payments that covered more than 7 million hospital discharges, according to CMS.

According to CMS, the Medicare Part B physician and supplier information allows for similar comparisons and is based on data from 950,000 providers who collectively billed Medicare $90 billion in 2013.

“Hospitals, physicians, and other health care providers determine what they will charge for services and procedures provided to patients and these ‘charges’ are the amount the hospital or provider generally bills for the service or procedure, but the amount paid is determined by Medicare’s physician fee schedule or other payment methodologies,” CMS said in a statement.