CMS Releases 2013 Hospital, Physician Data

The opening of this week’s Health Datapalooza conference in Washington was the setting for a new Medicare data dump on physician and hospital inpatient/outpatient payment and utilization rates.


The opening of this week’s Health Datapalooza conference in Washington was the setting for a new Medicare data dump on physician and hospital inpatient/outpatient payment and utilization rates.

This is the third annual release of data as part of the Obama administration’s information transparency initiative to promote increased quality of care and more informed healthcare spending by consumers.

Also See: Medicare Prescription Data Release Catches Flak from AMA

The hospital information includes inpatient charge data for fiscal year 2013, enabling comparisons of the average hospital charges for the 100 most common Medicare inpatient stays, as well as payment data of the top 100 inpatient discharges “to provide a point of comparison against hospital charges for the services,” according to a CMS statement. The top 100 inpatient discharges account for $62 billion in Medicare spending and more than seven million discharges.

Data can be compared by charges, costs and service utilization by individual hospitals, those in a local market or across the nation. Major joint replacement continues to be the top discharge and its total allowed amount cost was $6.6 billion in FY 2013. The average hospital charges per discharge for major joint replacement was $50, 116 in 2011; $52,249 in 2012 (up 4.3 percent); and $54,239 in 2013 (up 3.8 percent). Highest discharge rates were in the Midwest and Rocky Mountain regions and the lowest were in parts of the Northeast, parts of California and Nevada, and New Mexico.

The Part B physician and supplier payment and utilization data shows payment and submitted charges, and enables comparisons by physician, specialty, location, types of services/procedures, submitted charges and Medicare payment, according to CMS. The 2013 data covers 950,000 unique healthcare providers and totals $90 billion in fee-for-service payments.

The American Medical Association, as it has done in the past, issued a warning on the veracity of Medicare’s data. The organization contends the data is riddled with errors, does not explicitly include information on quality, does not properly count the number of services, lacks context and specificity to aid appropriate comparisons among providers and is not risk-adjusted, among other concerns.

A link to the inpatient dataset is here, the outpatient dataset is here and the physician/supplier dataset is here.

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