Health Care
5:22 am
Thu April 10, 2014

Medicare Data Could Change How Patients Choose Doctors

Originally published on Thu April 10, 2014 7:54 am

Transcript

(SOUNDBITE OF MUSIC)

DAVID GREENE, HOST:

This is MORNING EDITION from NPR News. Good morning. I'm David Greene.

When you're picking a restaurant or a hotel or a car you might want to buy, it has become so easy to go online, do research, compare and make the best choice. Not so when you're doing something far more important - like picking the right doctor. But in coming months, the government will be releasing more information about doctors.

In a first step, the Obama administration has now released detailed accounts of what the Medicare program pays out to individual doctors, records that had been closed for more than three decades. The data is from 2012, when $77 billion went to more than 880,000 health care providers under Medicare.

To understand how this and other information to come might empower patients, we turned to Charles Ornstein. He's a senior reporter at ProPublica - a non-profit investigative reporting news organization.

Charles, good morning.

CHARLES ORNSTEIN: Hi, David.

GREENE: So this data that's been released, what exactly does it show us?

ORNSTEIN: Well, this is a sort of a milestone moment. For the first time, we are able to see how much Medicare, which is a huge government program, is paying individual doctors and what services they're performing for patients who are in this program - the seniors and disabled patients who rely on Medicare for their health care.

GREENE: These records that we're getting, I mean they don't give us a full picture of a doctor's practice. So help me, as a patient and other patients, understand what exactly we can infer, what we can learn that we might not have been able to in the past.

ORNSTEIN: Well, just taking a step back, I mean think about it right now, when you're trying to pick a doctor, how do you do that?

GREENE: Mm-hmm.

ORNSTEIN: You look for a doctor that's near your house. You ask your friends and neighbors for recommendations. You may go to Yelp or Healthgrades to see what other people rate them. And if you're really, you know, adventurous, you may check to see if they've been disciplined by their medical board. But if you want to, sort of, see more than that, you want to see are they good doctor; there's been little you can do. So this begins - along with some other data - to tell you and to fill in those blanks. It can tell you whether your doctor's doing things that other doctors who are like him are not really doing. And once you begin to analyze it and look, for example, do every single one of a doctor's patients receive a particular test or procedure when only a quarter or 10 percent of another similar doctor's patients received that? I would then want to ask my doctor some questions.

GREENE: What you're talking about there, at least if I see a disparity, even if I don't necessarily understand what it means at the outset, I can start asking some questions.

ORNSTEIN: Exactly. We have some experience with this at ProPublica, where we took a look at the way that doctors prescribe drugs in Medicare's drug program. And what we found is huge, huge differences - differences in how doctors prescribe narcotics, differences in how doctors prescribe drugs that have been labeled dangerous for seniors. So when you actually begin comparing doctors to one another, that's where it gets really interesting.

GREENE: OK. So this data we're getting, it's going to tell us the types of procedures doctors are doing. It's also going to be telling us how much money doctors are receiving from Medicare. And that has been the focus of a lot of the early stories that have been coming out about this release.

ORNSTEIN: Right. Well, it should come as no surprise that some doctors make a lot of money.

(LAUGHTER)

ORNSTEIN: So I don't know that I'm blown away by this. And the Medicare program pays some doctors more than others. Now that could be a function of the fact that some doctors primarily treat Medicare patients and others have a more balanced mix of patients that come from private insurance plans, or Medicaid or pay out of their own pockets. So the money itself, in terms of raw numbers, doesn't really do much for me, but it does show why this is important for it to be released is this is a lot of public money and we deserve to know where it goes. But just seeing that a doctor makes a lot of money doesn't, to me, indicate that I should avoid that doctor or that I should suspect that doctor of doing something wrong.

GREENE: Charles Ornstein, you say there's going to be a lot of raw data here, how much Medicare money doctors are receiving, what sorts of procedures they're doing, but we're also expecting more information to be coming out from the government in the months ahead that could paint an even better picture of doctors, Right?

ORNSTEIN: Right. This is really exciting, that we're on the cusp of having just a flood of information. Beginning this fall, the government's going to be releasing data from every drug and medical device company on how much they pay physicians for things like speaking, and consulting, and research and meals. So you can see and begin to draw and looking at the drugs that doctors prescribed and who pays them in the types of procedures that they're doing and if they have relationships with makers of devices for those procedures, you can begin drawing connections. And I think the smart media outlets and other research groups that are able to connect these dots and make it in a way that's actually useful for consumers, that's where you're going to see consumer empowerment.

GREENE: Charles Ornstein from ProPublica, thanks very much, as always.

ORNSTEIN: Thanks for having me. Transcript provided by NPR, Copyright NPR.