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April 2006, Week 2

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From:
"L. Wood-Hill" <[log in to unmask]>
Reply To:
L. Wood-Hill
Date:
Wed, 12 Apr 2006 11:33:24 -0400
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multipart/related
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Thought this was worth sending.  You will be hearing alot about this issue
and should be prepared to talk about it on interviews!
 
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April 12, 2006
Editorial

Evaluating Doctors With Medicare Data 


The federal Medicare program is sitting on a trove of information that could
help employers and patients decide which doctors provide the best service at
the most reasonable cost. This is precisely the sort of information that
President Bush has been urging the health care system to make available so
that consumers can choose their doctors wisely. Yet the Department of Health
and Human Services, relying on an old and dated court decision, has turned
down a request for the data.

The conflicting perspectives were described by Robert Pear in yesterday's
Times. The Business Roundtable, which represents 160 large companies, asked
Medicare to release data on payments to individual physicians to help them
determine which doctors achieved the best results - performing the most knee
operations with the fewest complications and deaths, for example - and how
the average cost per case differs from doctor to doctor.

Releasing the information would help insurance plans and employers decide
which doctors to include in their networks. Properly scrubbed and evaluated,
the information could also help patients choose their doctors. 

To be sure, the raw data could be confusing. Individual doctors may have too
few patients with a given diagnosis to yield trustworthy statistics, or
their patients may be atypical; they may look good by one measure but bad by
another. Medicare is running pilot programs to test releasing the data for
physicians along with other measures of cost and quality, and it needs to be
presented in ways that are fair to the doctors and useful to patients. 

Federal health officials, however, feel constrained by a 1979 Federal
District Court decision, which blocked the disclosure of Medicare payments
to individual doctors as a violation of federal privacy laws. That case may
no longer be relevant, given that reimbursement patterns have changed. But
if necessary, Congress should amend the laws to allow disclosure.


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