- Center on Health Equity & Access
- Clinical
- Health Care Cost
- Health Care Delivery
- Insurance
- Policy
- Technology
- Value-Based Care
Medicare Data Release Still Contested, but Not Resisted
The American Medical Association (AMA) said it would not block the release of 880,000 physician billing records from the Medicare claims database. The government's decision to release the information is a response to the pressure they received from employers, insurers, and consumer groups for increased transparency and access to physician payment information.
The American Medical Association (AMA) said it would not block the release of 880,000 physician billing records from the Medicare claims database. The government’s decision to release the information is a response to the pressure they received from employers, insurers, and consumer groups for increased transparency and access to physician payment information.
Opening the records to the public could change how consumers choose their providers. Hard data will also shape the way physicians are rated and help identify fraud or low performers.
“Over the past 30 years, the landscape has changed with respect to physician information that is available to the public,” said Jonathan Blum, Medicare deputy administrator. “As a result, the healthcare system is changing from a system dominated by dearth of usable, actionable information to one where care coordination and dramatically enhanced data availability... will power greater innovation, higher quality, increased productivity, and lower costs.”
Some AMA members worry that any incorrect information listed in the records may create inaccurate depictions of some practitioners. They hope that the government will consider reviewing and revising the records before their release for public scrutiny.
“[A] broad approach to releasing physician payment data will mislead the public into making inappropriate and potentially harmful treatment decisions and will result in unwarranted bias against physicians that can destroy careers,” said AMA president Ardis Dee Hoven, MD.
The release will only include billing data for 2012; data for those doctors who treated 10 or fewer patients won’t be released. Additionally, while the AMA has voiced its opposition, many others are optimistic.
“This is a very good change in policy,” said Robert Krughoff, president of Consumers’ Checkbook, which rates insurance plans. “It is now up to consumer organizations to be sure the information is used in valid ways, and to be strongly critical of reports that use invalid methods that are misleading or unfair to physicians.”
Around the Web
Medical Assn Won’t Stop Medicare Doc Data Release
Laundromats as a New Frontier in Community Health, Medicaid Outreach
May 29th 2025Lindsey Leininger, PhD, and Allister Chang, MPA, highlight the potential of laundromats as accessible, community-based settings to support Medicaid outreach, foster trust, and connect families with essential health and social services.
Listen
New Research Challenges Assumptions About Hospital-Physician Integration, Medicare Patient Mix
April 22nd 2025On this episode of Managed Care Cast, Brady Post, PhD, lead author of a study published in the April 2025 issue of The American Journal of Managed Care®, challenges the claim that hospital-employed physicians serve a more complex patient mix.
Listen
