Ophthalmologists, oncologists and cardiologists received the most in Medicare payouts in 2012, according to a massive data dump of healthcare provider records yesterday by the Centers for Medicare & Medicaid Services.
All told, the data show payments to 880,000 providers, for about 6,000 types of procedure, totaling some $77 billion. The watershed release of more than 9 million records reveals that Medicare paid out some $5.59 billion to 17,067 ophthalmology providers in 2012, for an average payment of $327,239.
Payments to oncology providers (including hematology/oncology, radiation oncology and medical oncology) totaled $5.01 billion that year to 14,122 providers, for an average payment of $346,015. Cardiology received a total of $4.97 billion, or about $223,248 per payment to 22,241 providers.
Despite the unprecedented size of the release, the data provide only a limited window on U.S. healthcare spending. They don’t include any information on payments from non-Medicare patients, for example, and omit payments made by privately administered Medicare Advantage plans – about a quarter of the Medicare patient population.
And payments listed for 1 provider could include all billings for their practice or clinic. The data also leave out any procedures performed less than 11 times for each provider.
"Using this data, it will be possible to see lots of new information about how doctors practice and how they are payed [sic]. But this data is extraordinarily complex; it will be very difficult to draw secondary conclusions from it consistently," healthcare data expert Fred Trotter warned ahead of the release. "We should be very careful to not draw any conclusions at the low end of the spectrum. That doctor who ‘only’ performed procedure X eleven times? That probably means nothing. What the doctor is actually doing with his/her patients is just not showing up at all."