The Hill

Wyden: Medicare data should be more transparent

 Ron Wyden

Sen. Ron Wyden wants Medicare data to become more transparent.

Sen. Ron Wyden (D-Ore.) said on June 25 there is no reason why Americans should not have access to more Medicare data. Wyden, who was speaking at a Bipartisan Policy Center healthcare technology forum, said there should be transparency for where Medicare money goes, as well as comparison of medical prices among hospitals.

"For the first time, the American people will learn what Medicare pays for various services," Wyden said.

Wyden said 52 million people will be covered by Medicare in 2013, accounting for more than $50 billion, or 14 percent of federal spending.

"With this kind of public investment, it's pretty hard to juxtapose that with the argument that somehow this is all a private matter," Wyden said.

He pointed to the Centers for Medicare and Medicaid Services releasing information regarding common hospital charges and outpatient procedures as a limited but forward step towards healthcare transparency.

Wyden and Sen. Charles Grassley (R-Iowa) on June 18 reintroduced the Medicare Data Access for Transparency and Accountability Act (Medicare DATA Act), which calls for a database containing Medicare claims and expenditures. Grassley originally introduced the bill in 2011.

"Taxpayers have a right to see how their dollars are being spent," Grassley said at the time. "There shouldn't be a special exception for hard-earned dollars that happen to be spent through Medicare."

At the health IT forum, Wyden said a successful Medicare database would contain information on which doctors frequently perform specific procedures and price comparisons between inpatient and outpatient care.

"Healthcare can be transformed by the mountains and miles of data that are growing everyday, but only if it's accessible," Wyden said.

Mark Hogel, CTO for CMS, said that while the agency has received an increasing influx of medical data, quality and consistency are the biggest hurdles to access.

"The perfect place to ensure that you have high-quality data is at the point of creation," Hogel said. "We don't create our data; we receive our data."

Specifically, CMS receives Medicare information and other data from states, which presents discrepancy problems because of the variety of payment systems. Some states have more than one payment system.

"Sometimes I think we're not necessarily looking at the right data we should be looking at," Hogel said.

Privacy concerns are another procedural impediment. With the ability for personal medical data to be shared across an ever-growing number of entities, patients can choose not to have their records shared at all, invoking another variable that CMS must account for.

Hogel said he is interested in pursuing other types of data analysis, such as geospatial and zip code trends. Integrating medical data on a national level, he said, would allow Medicaid administrative contractors to isolate and compare specific regions regarding healthcare.

About the Author

Reid Davenport is an FCW editorial fellow. Connect with him on Twitter: @ReidDavenport.

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Reader comments

Wed, Jun 26, 2013 Linda El Segundo, CA

While I don't object to statiscal data being made more transparent, this kind of "transparency" should be easily obtained without a large bureacratic organization, using simple programs to extract and analyze payment data. It is unnecessary since the data already exists and just needs to be appropriately "mined". Specific information about Medicare payments for/to individuals and on their behalf to healthcare organizations should continue to be protected. And, I take issue with the statement "Taxpayers have a right to know ...." It is NOT the "taxpayers" money, of which I am one, BUT the individuals who have paid for their Medicare benefits' money. This is not money from someone's Federal income tax or property tax or sales tax . It is money specifically taken from our salaries for our later Medicare benefits. These are "earned" and paid for benefits. If the government had never taken Social Security and Medicare withholding funds and put them in with General funds, Social Security would not have a funding problem today or in 30 years. We pay and paid for our Medicare benefits and they should not be counted as "part of the Federal budget, general funds". The payments to Medicare should be kept in a separate fund and treated as "repayment" of peoples' "loan" to the government for, in my case, the 53 years that I have been working full time and continue to do so.

Wed, Jun 26, 2013 BR

Medicare already req uses our Social Security number as our Medicare claim number - right there in big, bold print - on the front of our Medicare health insurance card! All the talk about privacy and preventing a hacker from stealing our identity is a bunch of hogwash. If our records are submitted anywhere within the system, our SSN is going right along with it. I think it's high time our political leaders do something about this and NOT use our SSN as the Medicare claim number.

Wed, Jun 26, 2013

While we need better accountability of Government programs, the unfortunate side of what they are proposing is that the program will: likely be far more expensive than they estimate, take far longer to implement than planned, work far less efficient than they envision, not elimnate most of the fraud they are targeting, and likely be subject to another type of abuse (lookup the latest scandals in the GSA, IRS, EPA, and more). I wish that were not the case, but the track record of the Government, especailly in the last four years, leads most attentive people to pessimism when it comes to Government programs.

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