Monitor charges of outlier practitioners. Doctors, too, will now be able to see how their charges compare with others providing similar services. For years insurers have told providers in their networks how they rank with their peers when it comes to quality measures such as giving certain tests to diabetics. Insurers have told me that step often helps those with poor scores give better care. The same might happen with prices. Late last year, I interviewed officials at Independence Blue Cross in Philadelphia who had set up a system of tiered networks with consumers paying more if they wanted to use doctors and hospitals that charged Blue Cross more for their services. Blue Cross told me some of the hospitals with higher charges voluntarily lowered them in order to belong to the carrier’s lower-cost network tiers. It’s too early to say the HHS release will bend the proverbial cost curve, but it’s something to watch. Presumably HHS will continually update these data. How about watching how the doc charges change over time?
With promise also comes peril, and reporters need to use and interpret the data with care, as Charles Ornstein wrote at the Association of Healthcare Journalists Covering Health blog. As Ornstein notes, the data set is enormous—not something to be analyzed in Microsoft Excel—and that “could well serve as a barrier for smaller news organizations,” he writes, suggesting partnerships with academic institutions or other news outlets. Among Ornstein’s other sensible caveats for reporters: keep in mind that while this data is vast, there is still plenty that is not included (private insurance payments, for one); and, there are legit, non-fraudulent reasons a doctor might receive large payments from Medicare (several doctors in a practice may bill under one doctor’s name, for example).
In sum: working with this data will take time; don’t rush to conclusions. Those “top billers,” for example? They are, as Sarah Kliff put it at Vox on Wednesday, “likely really great doctors—or they might be criminals. We don’t know which quite yet.”
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