MDNews - Central New York

T HE APRIL RELEASE by the Centers for Medicare & Medicaid Services (CMS) of 2012 Medicare physician reimbursement data has prompted a lot of discussion among medical profes- sionals and others. A local newspaper published individual reimbursement figures for a number of physicians in specialties that treat large numbers of Medicare recipients with high-tech equipment and pricey drugs. Unlike professional athletes, movie stars and entertainers, physicians are not accustomed to seeing stories in the newspapers about how much they earn. I am reminded of a conversation I had several years ago with the president of the Pennsylvania State Medical Society at a medical conference in downstate New York. The subject of publicity came up. The physi- cian admitted he was of the old school and believed people should have their names in the newspaper only three times in their lives: "when they are hatched [born], matched [married] and dispatched [deceased]." Unlike people in other lines of work, most physicians shun publicity. A politician admitted to me he did not mind seeing his name in the newspaper if it was spelled correctly. In 2012, more than 880,000 medical professionals received $77 billion for caring for Medicare recipients. Headlines in newspapers, the Internet and other com- munications media often implied that physicians are profiteering at the expense of Medicare and senior citizens. One such headline was "Doctors Make Millions off Medicare." The national statistics showed that hematology/oncology, radiation oncol- ogy, ophthalmology, medical oncology, rheumatology and cardiology received the most Medicare physician reimbursement. There was little or no mention that these medical professionals were treating cancer, heart disease and ailments that threatened patients' lives and eyesight. The medications they prescribed have saved countless lives, extended and improved the quality of lives of many patients, and frequently relieved unbearable pain. Follow-up comments from physicians, physician organizations and even a former senior citizen leader had a similar theme — the raw data was misleading. In many instances, one listing of a physician's name in a group practice with his or her Medicare reimbursement really covered all of the physicians in the practice. Ardis Dee Hoven, MD, President of the American Medical Association, said: "The AMA is concerned that CMS's broad approach to releasing physician payment data will mislead the public into making inappropriate and potentially harmful treatment decisions and will result in unwarranted bias against physicians that can destroy careers. We have witnessed these inaccuracies in the past." Dr. Hoven asked, "How does a physician or a practice get its reputation back?" This is a tremendous challenge in the era of social media. Also not to be forgotten is that physician reimbursement can involve the cost of very effective and often very expen- sive drugs, if physicians purchase them from drug companies as opposed to the purchases made by patients or others on their behalf. For most physicians, Medicare benefi- ciaries represent a significant portion of their patient base, but Medicare reimburse- ment is less than usual and customary fees. Physicians are caregivers first and foremost, but many are part of the management of a practice, which is, after all, a business in which the bottom line cannot be avoided or ignored. Constant financial headaches are leading growing numbers of physicians to sell practices and become employees. The dollars-and-cents facts of physicians' lives are something the general public does not care about or understand. The Medicare physician reimbursement data was released after hospital reimburse- ment statistics first went public last year. David R. Halleran, MD, President of the Onondaga County Medical Society in Syracuse, says the data "lacks context and can lead to people jumping to wrong conclu- sions." Dr. Halleran made it clear he had no problem with transparency, a sentiment shared by many physicians. The physician and hospital reimbursement data has become available to the public after courts have lifted bans on release of this data that have been in effect since 1979. Robert Krughoff, President of Consumers' CHECKBOOK, said, "This data is important because it will make it possible for consum- ers to identify physicians that will best meet their needs." To those concerned that data could misrepresent a physician practice, Krughoff said: "The consumer organizations that have pushed for release of this informa- tion have a strong obligation to make sure that the information is used properly." That sounds good, but can the consumer orga- nizations or anyone else really deliver on this noble promise? Don't bet on it! Gerald N. "Jerry" Hoffman was chief execu- tive officer of the Onondaga County Medical Society from 1981 to Jan. 31, 2014, when he retired. He is co-author of two books, Medical Malpractice Insurance: A Legislator's View and The History of Local Medical Care: 1806-2006. ■ +++++++++++++++++++++++++++++++++ +++ + +++ + +++++++++++++++++++++++++++++++++ HEALTHCARE PERSPECTIVE By Jerry Hoffman By Jerry Hoffman Medicare PS on Reimbursement Data M D N E W S . CO M ■ MD NEWS Central New York | 5

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