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SHOCKING Data release shows Medicare needs a firmer grip on costs

By Chicago Tribune

The Sun's editorial writer is out of the office this week. The following editorial is republished from Thursday's Chicago Tribune.

Federal officials released a huge trove of data Wednesday that shows what Medicare has paid to more than 880,000 doctors and other health care providers nationwide. There were some eye-popping stats:

n About 2 percent of doctors collected about a quarter of the $77 billion in payments in 2012.

n An ophthalmologist in West Palm Beach, Fla., topped the list by raking in more than $26 million to treat fewer than 900 patients. That is 61 times the average Medicare payout of $430,000 for an ophthalmologist.

n A Florida cardiologist earned $23 million in Medicare payments, nearly 80 times the average for that specialty.

Those numbers no doubt shocked a lot of Americans. It was news to them. It was not news to Medicare officials, though. They've had this information all along.

Medicare, the federal health care system for the aged that spends more than $500 billion a year, faces an uncertain future. It desperately needs to be more efficient. The data released Wednesday suggest this system has a long, long way to go to control its costs.

Now, high Medicare payments to particular doctors or institutions are not by definition signs of waste or fraud. Some doctors justifiably earn more because they're trained in specialties. Some treat patients who require more constant care. There are major regional variations in how doctors practice.

Americans want their doctors to be good. High compensation draws talented people to medicine and to Medicare.

They also want Medicare to survive ... but that's going to require a far more efficient system.

The release of this data is an important step toward that goal. For the first time, Americans can see what individual doctors charged, and what Medicare paid, for thousands of services and procedures. That means doctors who bill Medicare for performing more procedures than reasonably could be accomplished in a day face greater odds that they'll be questioned. The same goes for doctors who overtreat patients by ordering extraordinary numbers of tests, or who treat a suspiciously high number of patients who are diagnosed with extremely rare conditions.

The American Medical Association has fiercely fought this kind of information disclosure, arguing that it's an invasion of physicians' privacy. (The information does not reveal any details about patients.) Last year, thankfully, a federal judge cleared the way for the release of the information that came out Wednesday.

The AMA warned in a statement that "releasing the data without context will likely lead to inaccuracies, misinterpretations, false conclusions and other unintended consequences." AMA officials fear that doctors will come under unreasonable suspicion just because they've reaped large payments over a year. That such information could "mislead the public into making inappropriate and potentially harmful treatment decisions."

How about if we trust patients and taxpayers to digest this information, debate this information, listen to people put it in context ... and make their own conclusions?

We have long backed efforts by government and advocacy organizations to give Americans better access to information on doctors and hospitals.

Illinois has an extensive hospital report card that helps consumers judge quality of care: healthcarereportcard.illinois.gov.

The Centers for Medicare and Medicaid Services posts some hospital quality measures, including readmission rates and other measures, at hospitalcompare.hhs.gov.

Several clinical quality measures for doctors are available at medicare.gov/physiciancompare.

Medicare officials said at a news conference Wednesday that they hope outside researchers and organizations will put this newly released information and other data into user-friendly websites to help consumers search for the best care, and to help pinpoint waste and fraud.

This nation received some valuable new information Wednesday. Let's make good use of it.

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