This past month, Medicare announced that it will permit access to its extensive claims database by consumer groups and employers to access doctors and hospitals.  Healthcare providers and facilities will be rated according to how often a procedure is performed and the problems that could have been prevented.

While physicians will be identifiable, patient personal data will not be disclosed. According to David Lansky, president of the Pacific Business Group on Health, “This is the beginning of a process to give us the information to make informed decisions.” His nonprofit group represents 50 employers from large companies that provide coverage for more than 3 million people. He further states his approval by saying “There is tremendous variation in how well doctors do, and most of us as patients don’t know that.  We make our choices blind”.

Marilyn Tavenner, the acting administrator for Medicare concurs, calling the new policy ” a giant step forward in making our healthcare system more transparent and promoting increased competition, accountability, quality, and lower costs.”

President Obama’s healthcare reform paved the way for this step by amending federal laws to allow release of the information.

This is however not without snags as I see it:

  • Will this discourage physicians from accepting high-risk cases for fear that their success rates will decline?
  • Has a formula been devised to reflect the number or percent of high-risk patients that are accepted?
  • What about a physician that does not accept Medicare and Medicaid?  How will this physician be rated?
It will be interesting to see how this plays out in the new year as we move forward.
Let’s keep an eye on this one.
Have a happy and healthy new year.