CMS NEWS: Updates to Data Initiatives Increase Transparency of the Medicare Program

CMS NEWS

FOR IMMEDIATE RELEASE                                  
May 5, 2016

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Updates to Data Initiatives Increase Transparency of the Medicare Program

Data serves as a rich resource on Part B costs, services, and trends 

As entrepreneurs, investors, data scientists, researchers, policy experts, government employees, and others prepare to gather for the seventh annual Health Datapalooza conference in Washington, D.C., the Centers for Medicare & Medicare Services (CMS) is releasing updated data to increase transparency in the Medicare program.  Today CMS is posting the third annual release of the Physician and Other Supplier Utilization and Payment public use data.  In addition, CMS is announcing the availability of more timely data for researchers. 

“This week’s announcements underscore CMS’ ongoing commitment to releasing data and information to promote a vibrant health information economy,” said CMS Chief Data Officer Niall Brennan. 

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 data includes payment and submitted charges, or bills, for services and procedures provided by each physician or supplier. It allows for 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). New in the 2014 data is 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. 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 LDS request process. With the changes announced today, researchers will be able to request updates to their 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.

The release of timely, privacy-protected data is especially important as the Medicare increasingly pays providers based on the quality, rather than the quantity, of care they give patients.  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.