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April 10, 2014 at 10:22 AM
On the one hand, I’ve been a data junkie for so long that I can remember being thrilled when I could do the database searchers on CD-ROMs, rather than going through libraries’ bound volumes of musty old magazines for the data.
So, I truly love the new 2012 Medicare physician pay database. I tried plunking the name of about every doctor I’ve ever personally met into The New York Times’ version of the database.
Ordinary people who stare at me blankly when I try to explain what I do for a living came up to me and lectured me on how we all should rise up and revolt against all of those greedy eye doctors.
I know from first hand experience that, whatever tendency toward stonewalling that health insurance companies may possibly have, doctors have a strong tendency of their own to game the system.
But, on the other hand, I think looking at provider pay data is an example of where you have to be a kraken to have enough hands to deal with all of the arguments for and against the proposition that certain providers, or groups of providers, were underpaid, or overpaid, or paid in some other way that helped or hurt the cost or quality of health care.
Some high-billing doctors may simply include more equipment and drug costs in their bills than others because that’s how their specialties work.
Some apparently low-billing doctors may have figured out to milk Medicare like a cow by splitting a huge volume of fraudulent claims into many innocent-looking, hard-to-group transmissions.
The smartest Medicare con artists will never appear near the top of any Excel spreadsheet column that’s sorted by dollar volume because they have thought long and hard about how to look tediously average.
