For decades the public could not see what doctors and other practitioners billed Medicare for seeing patients; nor could the public learn how much Medicare paid for outpatient procedures.
That data is now available, thanks to a lawsuit brought by the Wall Street Journal and Dow Jones. The nonprofit investigative journalism outfit ProPublica has turned all of that information into a searchable database, so that patients and their families can compare their own doctors to others, for example.
According to ProPublica, when doctors in Colorado bill Medicare for care, they are slightly more likely than doctors in other states to charge rates at the high end of the spectrum.
Charles Ornstein is a senior reporter for ProPublica who worked on the project. Ornstein hastens to say the rate at which doctors in Colorado bill at Medicare's highest level -- 5.4 percent -- is only slightly higher than the national average of 4 percent. He tells Colorado Matters' Elaine Grant that he's not sure why doctors here more often charge more. But, he says, Medicare sets rates by region, and that the agency typically does not pay the rates that doctors charge. The ProPublica database includes both the rates practitioners have charged and the amounts Medicare has paid.
The Medicare payments database is one of several projects ProPublica is undertaking to make the world of medicine more transparent for the public. In another ongoing project, ProPublica organizes data that reveals payments made to doctors by pharmaceutical companies.
Ornstein says patients, their families and taxpayers have a lot at stake -- and that as more and more data is shared with the public, consumers should have greater control over the quality and cost of their health care. "I think we’re on the edge of a huge revolution of data in medicine that’s going to change, over the next couple of years, how we choose our health providers and how we interact with our health providers," he says.
As one example, Ornstein says, patients can use the ProPublica database to learn more about prospective doctors, rather than the far less thorough practice of choosing a new physician based on a referral from a friend or by proximity -- two of the most common ways Americans currently choose physicians. "We can certainly rely on trust, but we’ll also be able to do some verification,” Ornstein says.
