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What does all that healthcare data really mean?

Kenneth Corbin | Dec. 4, 2014
Bringing more data into the public domain may be a critical step toward increasing transparency in the famously opaque healthcare sector, but raw data alone will only go so far, experts warn.

Some of that information was included in last year's release of billing data for some 3,000 hospitals, the first release of its kind, which offered side-by-side comparisons that unveiled wide swings in billing rates for the same procedures at comparable facilities and garnered significant attention in the popular press.

"It highlighted massive variation in hospital charges for the same procedures often in the same geographic area and certainly nationally," Brennan says. "I think it really resonated with people, frankly I think more than we thought it would."

The reaction within the community of care providers to broadening access to health data has been mixed, with some groups voicing concerns about the accuracy of the information and the lack of context leading to erroneous interpretations.

Charles Cutler, an internist and the immediate past chair of the American College of Physicians, warns that aberrantly high Medicare billing rates alone are not enough to indict a practitioner for bilking the system.

In some practices, Cutler argues, a physician's patient base might be disproportionately comprised of Medicare beneficiaries, and the cumulative charges reported in CMS data might be perfectly legitimate.

"Simply because costs are high, we have to be careful not to attribute that that is somehow fraudulent or that the high utilizer is wasting services," Cutler says.

"He or she may be," he acknowledges, but "we have to be careful that there's not guilt by association."

 

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