Federal Government Releases Claims and Payment Data

In an effort to make the opaque U.S. healthcare system more accountable, the federal government continues to release Medicare claims and payment information. The most recent reporting centered on 2013 Medicare Part D drug spending, inpatient and outpatient hospital charges, and payments to physicians. The goal of releasing the information is to give the public an opportunity to see how the government manages pharmaceuticals for seniors, as well as “facilitates a vibrant health data ecosystem, promotes innovation and leads to better-informed and more-engaged healthcare consumers,” said Niall Brennan, the Centers for Medicare and Medicaid Services’ (CMS) chief data officer.

CMS reported that in 2013, Medicare’s Part D prescription drug program spent $103 billion. The data show the names, locations and specialties of physicians and healthcare organizations who submitted drug claims to Medicare, as well as the names, costs and number of prescriptions for each individual drug. Medicare is projected to absorb $76 billion of taxpayer money in 2015 (about 12 percent of Medicare spending) after accounting for premiums seniors pay, according to the Congressional Budget Office.

In June, CMS released three new sets of data. The latest data show what hospitals charged and what Medicare paid those hospitals for 100 of the most common inpatient stays and the 30 most common outpatient procedures. The inpatient data cover more than seven million discharges and $62 billion of Medicare money. Physician data encompass 950,000 physicians, nurse practitioners and other providers and $90 billion of Medicare funds. Spending on hospitals and physician services makes up a majority of U.S. healthcare expenses.