Wyden: Medicare data should be more transparent

Sen. Ron Wyden (D-Ore.) said on June 25 there is no reason why Americans should not have access to more Medicare data. Wyden, who was speaking at a Bipartisan Policy Center healthcare technology forum, said there should be transparency for where Medicare money goes, as well as comparison of medical prices among hospitals.

"For the first time, the American people will learn what Medicare pays for various services," Wyden said.

Wyden said 52 million people will be covered by Medicare in 2013, accounting for more than $50 billion, or 14 percent of federal spending.

"With this kind of public investment, it's pretty hard to juxtapose that with the argument that somehow this is all a private matter," Wyden said.

He pointed to the Centers for Medicare and Medicaid Services releasing information regarding common hospital charges and outpatient procedures as a limited but forward step towards healthcare transparency.

Wyden and Sen. Charles Grassley (R-Iowa) on June 18 reintroduced the Medicare Data Access for Transparency and Accountability Act (Medicare DATA Act), which calls for a database containing Medicare claims and expenditures. Grassley originally introduced the bill in 2011.

"Taxpayers have a right to see how their dollars are being spent," Grassley said at the time. "There shouldn't be a special exception for hard-earned dollars that happen to be spent through Medicare."

At the health IT forum, Wyden said a successful Medicare database would contain information on which doctors frequently perform specific procedures and price comparisons between inpatient and outpatient care.

"Healthcare can be transformed by the mountains and miles of data that are growing everyday, but only if it's accessible," Wyden said.

Mark Hogel, CTO for CMS, said that while the agency has received an increasing influx of medical data, quality and consistency are the biggest hurdles to access.

"The perfect place to ensure that you have high-quality data is at the point of creation," Hogel said. "We don't create our data; we receive our data."

Specifically, CMS receives Medicare information and other data from states, which presents discrepancy problems because of the variety of payment systems. Some states have more than one payment system.

"Sometimes I think we're not necessarily looking at the right data we should be looking at," Hogel said.

Privacy concerns are another procedural impediment. With the ability for personal medical data to be shared across an ever-growing number of entities, patients can choose not to have their records shared at all, invoking another variable that CMS must account for.

Hogel said he is interested in pursuing other types of data analysis, such as geospatial and zip code trends. Integrating medical data on a national level, he said, would allow Medicaid administrative contractors to isolate and compare specific regions regarding healthcare.