CMS Launches Physician Payment Website

CMS has launched its online Open Payments System, which aims to boost transparency by making public the payments health care providers receive from drugmakers and medical device manufacturers, Modern Healthcare reports (Lee, Modern Healthcare, 9/30).

Details of Database

The Open Payments System, which is required under the Affordable Care Act's Sunshine Act, aims to boost transparency by making public what payments health care providers have received from drugmakers and medical device manufactures (California Healthline, 8/29).

The database initially includes payments made to chiropractors, dentists, physicians, podiatrists and optometrists (Alonso-Zaldivar, AP/Washington Times, 9/30). The data show payments made during the last five months of 2013, including:

• Consulting fees;
• Gifts;
• Research grants; and
• Travel payments (Adams, CQ HealthBeat, 9/29).

The database divides the records into three categories:

• General payments;
• Research payments; and
• Physician ownership and investments (Modern Healthcare, 9/30).

In addition, the data include physicians' ownership stakes in "group purchasing organizations," which buy drugs and devices for broader populations (AP/Washington Times, 9/30).

The data show manufacturers made 4.4 million payments to 546,000 physicians and 1,360 teaching hospitals during the time frame valued at $3.5 billion (Modern Healthcare, 9/30).

However, CMS said last month that about one-third of CMS Open Payments Systems records will be withheld upon launch because of data inconsistencies. CMS gave providers until Sept. 25 to review and request corrections to data (California Healthline, 8/29).

The database originally was intended to allow consumer to search for their own physicians' information, but that functionality is not yet ready, according to the AP/Times (AP/Washington Times, 9/30).

Debate Over Database Continues

Last month, the American Medical Association and more than 100 other medical professional groups in a letter asked CMS to delay the launch of the database by six months, expressing concern that the database "will not be ready and will likely lead to the release of inaccurate, misleading and false information" (California Healthline, 8/29). AMA since has added that CMS did not give providers enough time to review the data.

AMA President Robert Wah said relationships between providers and manufacturers are "appropriate" and "can help drive innovation in patient care."

Healthcare Leadership Council President Mary Grealy said, "My biggest concern is it will have a chilling effect, and physicians will say 'I don't want to see my name on a list'" (AP/Washington Times, 9/30). She said that consumers might not understand "the value of physicians and hospitals and drug companies and devicemakers interacting with each other in a way that improves health care."

The American Osteopathic Association said it "is concerned these complex reports will cause further confusion to the public if released at this time."

Feds, Lawmakers Defend Database

Federal officials defended the database and said they would provide contextual details so that patients can understand the information (CQ HealthBeat, 9/29).

Meanwhile, Sen. Chuck Grassley (R-Iowa), who has championed the system in Congress, expressed hope that the database will become a consumer resource. He said, "The patient who is prescribed a drug that might be beneficial yet risky will be able to learn whether the prescribing doctor accepted drug company money to study the risks. The information might not change the outcome, but it's something a patient might like to know" (AP/Washington Times, 9/30).

Independent Investigation Gives Preliminary Findings

In related news, an independent investigation by ProPublica provides a first look into trends that could be found in the Open Payments System, New York Times' "The Upshot" reports.

ProPublica for the past four years has collected details of physician and pharmaceutical industry relationships as part of its Dollars for Docs project. The data were collected from some large drugmakers' websites. The 17 companies detailed accounted for about half of all drug sales in the U.S. last year.

The data show some initial findings, including:

• 3.4 million payments totaling more than $4 billion made to physicians since 2009, including $2.5 billion for research;
• Some providers received payments from six or more drugmakers in a given year;
• Some small companies spent nearly as much as larger companies on such payments; and
• Meals were the most commonly reported benefits to providers, although they accounted for a significantly smaller share of the total cost (Ornstein et al., "The Upshot," New York Times, 9/29).