Medicare Data Show Top 1% Receive 14% Of Total Payments

Medicare Data Show Top 1% Receive 14% Of Total Payments

It’s been a long time coming. For the first time since 1979, data on how much doctors are paid by Medicare is publicly available. Last year, a federal court lifted an injunction that had been in place for 33 years, and today the Obama administration released the long-awaited Medicare payment data.

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Overview of 2012 Medicare payment data

Medicare actually paid out a total of $99 billion in 2012, but providers who performed less than 10 procedures and the category of “durable medical equipment” were not included, so the data only includes details on $77 billion of the total payments. Furthermore, the data released today only includes Medicare Part B claims such as doctor visits, lab tests and other outpatient treatments. The money was paid out in reimbursement for more than 5,000 different medical procedures.

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The data showed that 344 physicians and other health providers received over $3 million each in 2012. The top 1,000 highest-paid doctors took in $3.05 billion in payments. Furthermore, the top 1% of the 825,000 medical providers accounted for more than 14% of the $77 billion in total billings. The top 2% of healthcare providers represented around 23% of total Medicare fees.

Thirteen doctors received more than $10 million each, with the highest-paid doctor receiving $26 million (for fewer than 900 patients) and the second highest-paid receiving $23 million.

Controversy surrounding release of data

There has been a great deal of controversy surrounding the release of Medicare payment information since the first freedom of information requests back in the late 1970s.

The American Medical Association was against the release of the Medicare data.

AMA President Dr. Ardis Dee Hoven said they were worried that inaccuracies in the data or misinterpretation might unfairly hurt the reputation of some doctors.

She pointed out that although some physicians might seem to be billing large amounts to Medicare, often an entire practice submits bills under a single physician’s name. She also said in many cases high-Medicare-volume physicians are actually in-demand experts in their field who may now be portrayed in a poor light.

“How does a physician or a practice get their reputation back?” Hoven asked.

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