Top 2% of docs account for one-quarter of Medicare payments

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 - Medical Money

According to long-awaited data on Medicare payments, 2 percent of physicians received about $15 billion from Medicare in 2012, which equals roughly one quarter of total payments that year.

The data, made public by the Centers for Medicare & Medicaid Services (CMS), contains information on 880,000 physicians and other healthcare providers who took in about $77 billion in payments in 2012.

Looking beyond the top 2 percent, an analysis of the data conducted by The New York Times found one-quarter of physicians were responsible for about three-quarters of the spending.

A separate analysis from the Wall Street Journal found a total of 344 physicians and other providers were paid more than $3 million each in 2012.

Breaking down the data by specialty, hematology/oncology had the highest average amount paid per provider at $366,677. Radiation oncology, ophthalmology, medical oncology and portable x-ray specialists rounded out the top five. Cardiology was the eighth highest paid, with an average of $223,248 in Medicare payments per provider.

Certain procedures played a big role in boosting payments. For example, the 37 highest paid radiation oncologists received a total of $63 million for delivering intensity-modulated radiation therapy, one of the procedures that contributed the highest billings, according to The Wall Street Journal.

Some organizations are concerned that the release of this type of payment information could have unintended consequences, and the American Medical Association (AMA), among others, have tried to prevent the release of this data in the past.

Now that the data is public, Ardis Dee Hoven, MD, president of the AMA, released a statement saying that while the AMA is committed to transparency, this payment data has severe limitations and by itself doesn’t paint an accurate picture of the value or quality of care being delivered.

"We believe that the broad data dump today by CMS has significant short-comings regarding the accuracy and value of the medical services rendered by physicians. Releasing the data without context will likely lead to inaccuracies, misinterpretations, false conclusions and other unintended consequences.”

A searchable database of the Medicare payment information by physician is available through the Wall Street Journal.