The Centers for Medicare and Medicaid Services' (CMS) release of payment data sparked plenty of dramatic headlines across the country, but sweeping pronouncements may need to be approached carefully until the information is fully analyzed from multiple perspectives, including overall usefulness.
On April 9, CMS opened public access to payment records on more than 880,000 providers, including almost 37,000 physical therapists (PTs), 48 of whom are listed in the top 2% of providers receiving payment. News sources quickly reported on the overall data, with some even offering an online tool to look up information on providers.
While almost all media outlets tagged the release with headlines pointing to "big payouts" for a small percentage of providers—the New York Times' headline of "Sliver of Medicare Doctors Get Big Share of Payouts" being 1 such example—at least 1 news source noted the need for a more nuanced approach. In its article on the release, the Los Angeles Times reports that "federal officials cautioned against drawing sweeping conclusions about individual doctors from the numbers. High payouts do not necessarily indicate improper billing or fraud, they say. Payments could be driven higher because providers were treating sicker patients who required more treatment or because their practice was focused more on Medicare patients."
APTA staff members are reviewing the data and its organization, and already have one caveat. “It’s important to look at this data in context,” said J. Michael Bowers, chief executive officer of APTA. “It should not be used to draw conclusions about physical therapists and physicians without information about expenses, quality of care, complexity of patients, and volume of patients treated.”
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