CMS releases data on Medicare Part B services, procedures

Physician utilization, payment data crucial for value-based pay, says Niall Brennan.


The Centers for Medicare and Medicare Services is releasing updated healthcare data to increase transparency in the Medicare program and to provide more timely data for researchers.

The data represents the agency’s third annual release of the Physician and Other Supplier Utilization and Payment public use data, and is timed to coincide with the Health Datapalooza conference being held next week in Washington, according to a CMS announcement. Niall Brennan, chief data officer at CMS, said the release is part of an agency commitment to promote a vibrant health information economy.

“The release of timely, privacy-protected data is especially important as the Medicare increasingly pays providers based on the quality, rather than the quantity, of care they give patients,” said Brennan. “These initiatives contribute to a wide set of CMS activities focused on achieving better care, smarter spending and healthier people throughout the healthcare system.”

CMS’s goal is to shift Medicare payments from volume to value, tying 30 percent of traditional Medicare payments to alternative payment models and tying 85 percent of all traditional Medicare payments to quality or value by the end of 2016.

To help providers measure their progress, the Physician and Other Supplier Utilization and Payment data to be released contains summarized information on Part B services and procedures provided to Medicare beneficiaries by physicians and other healthcare professionals, including payment and submitted charges, or bills, for services and procedures provided by each physician or supplier. According to CMS, the value of the data is that it enables comparisons by physician, specialty, location, types of medical services and procedures delivered, Medicare payment and submitted charges.

The release of the updated 2014 dataset has information for more than 986,000 providers, up from 950,000 in 2013. The 2014 data also reflects provider payments of $91 billion in Medicare payments, compared to $90 billion in 2013.

A new component of the 2014 data is the Medicare standardized payment amount, which removes geographic differences in payment rates for individual services, such as those that account for local wages or input prices, and makes Medicare payments across geographic areas comparable.

CMS contends that it is also making more timely extracts of Medicare claims data available to researchers who access this data via Limited Data Sets (LDS). In the past, researchers have only been able to request annual extracts of Medicare data under the LDS request process. However, the agency makes the case that researchers now will be able to request updates to their LDS claims files on a quarterly basis.

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