NPA is excited to share this post from ProPublica’s award winning journalist Charles Orenstein
On the day Medicare released a trove of doctor data last month, a number of large news organizations published quick-and-dirty searchable databases that allowed users to see how much doctors earned from Medicare in 2012. They were on top of the news but showed results in isolation and out of context. They did not allow patients to see how their doctor’s numbers compared to their peers, only really how much money they made.
That’s why I’m super excited to tell you about our brand-new project, Treatment Tracker. It’s ProPublica’s app based on the Medicare data. And we have an interesting story that looks at how doctors bill Medicare for office visits, the bread and butter of their practices.
This took some time. The data itself is big and complex. We interviewed experts to understand which comparisons would be most meaningful in the data. We looked for top-line numbers that could serve as easy benchmarks people could understand quickly. One was Medicare services per patient, another was payment per patient. We also took a careful look at intensity of established-patient office visits as a benchmark that would be interesting and easily understood by readers. Some specialties, like psychiatry and oncology, have on average much more intensive and costly office visits. But in many specialties where the typical such visit is less likely to be so intensive, doctors can vary widely from the mean.
If you see that your doctor has a lot more or a lot fewer high-intensity visits than the average doctor like him/her, it doesn’t automatically mean there’s something wrong, but it’s one of the things worth having a conversation about.
What sets our app apart is that it allows you to compare your doctor to others in the same specialty and state. While it may satisfy your curiosity to know how much money a doctor earns from Medicare, it tells you little. We think it’s more useful to look at how a doctor practices medicine (the services they perform, the percentage of patients who got them and how often those patients got them). Our app gives you that information in context.
You can easily spot which doctors appear way different using red notes and orange warning symbols. Again, it’s worth asking questions if your doctor (or other health provider) looks different than his/her colleagues.
Our story looks at office visits for patients that health professionals have seen at least once before. Medicare paid for more than 200 million of them in 2012. Doctors and their staffs bill Medicare for visits on a 1 to 5 scale, with 5 being the most complex and the most expensive. Nationwide, about 4 percent of visits were billed at level 5, but we found 1,800 health professionals who charged their visits as 5’s at least 90 percent of the time. We ask why Medicare hasn’t done more about this issue despite years of warnings.
Huge kudos to my colleagues Ryann Jones and Lena Groeger, the muscle behind the app. Also, thanks to Scott Klein, Mike Tigas, Sisi Wei, Amanda Zamora, Gerald Rich, Jeff Larson, Robin Fields, Nicole Collins-Bronzan and Minhee Cho for their work on this project. It was truly a team effort.