New medical data create new opportunities

Starting Wednesday, the federal government is releasing health care data that have never before been available to the general public — numbers that show what doctors who treat Medicare patients charge the government and what they are actually paid.

Doctors groups have fought for years to stop this kind of data from being released, but the Obama administration recently decided to change course and release the numbers. The major release has excited health care observers and entrepreneurs, who are eager to discover new insight into the nation's health care system through the use of this data.

This move follows other efforts by the Obama administration to bring more transparency into health care costs. Though many national groups, such as the American Medical Association, have been wary of the data dump, several local health care executives support the move.

"We see this as a net positive as it continues the trend towards bringing greater transparency to health care," said Doug Ghertner, CEO of Change Healthcare, a local company that serves employers and strategic partners by helping track the true cost of health care procedures.

"There's more to reducing costs than just knowing the numbers, so releasing (Centers for Medicare and Medicaid Services) data is a first step," said Clayton Nicholas, Change's vice president of strategy and marketing. "Next, customers need to know what to do with the information and be empowered to take action with it."

The new data could aid the health care industry's shift from volume to value, said Clay Richards, CEO of Nashville company naviHealth, which aims to help clients find high-quality, low-cost treatment options for long-term care patients.

"The Medicare fee-for-service reimbursement system has historically incentivized volume," Richards said. "In our experience, greater transparency leads to improved practice patterns and, ultimately, better outcomes at lower costs."

Improved outcomes
Greater transparency in other areas has already led to improved outcomes, said Dan Hogan, CEO of health care technology company Medalogix. "I am a big fan of the transparency that this administration is pushing" — namely, he says, because "if you are aware of the situation, you can begin to improve it."

He says that already the administration's transparency push has better aligned provider motives with patient care. "Say what you will about Obamacare or the Affordable Care Act — our data is indicating that providers are diligently preparing themselves to be measured by outcomes."

There are several caveats to this new data: They will not reveal information about payments that physicians receive from private insurers. They will not include data for services performed on 10 or fewer Medicare members because of patient privacy concerns.

But for all the things the data don't include, perhaps the most remarkable takeaway is that they were released at all. For many, this marks the largest opportunity yet to look behind the curtain to see how doctors are paid.

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