October 7, 2014
By Michael J. McLafferty, CPA, MBA, FACHE, FHFMA, FACMPE
The first batch of Open Payments data connecting your physicians to financial arrangements with certain businesses was published online September 30. Your physicians’ financial data may not be on the CMS website now even if it was collected, but that doesn’t mean it won’t be there eventually.
The data collection mandated by the federal Sunshine Act and performed from Aug. 1 to Dec. 31, 2013, is broken into three categories:
- General payment details including all payments or other transfers of value from applicable group purchasing organizations (GPOs) or manufacturers to physicians and teaching hospitals that have nothing to do with research agreements or protocols;
- Research payment details for those payments or transfers of value that do involve research agreements or protocols; and
- Physician ownership information about physicians who have an ownership or investment interest in a manufacturer or GPO.
Your data could be there but ‘de-identified’
The data your doctors’ financial partners submitted may not be identifiable, or tied to your providers, in this edition of Open Payments.
About 4.4 million records have been collected, but CMS estimates that 40% of them — which would come to 1.76 million records — have been stripped of identifying details, or “de-identified,” while 199,000 other records are not published at all.
All the records were checked against the National Plan & Provider Enumeration System (NPPES); the Medicare Provider Enrollment, Chain and Ownership System (PECOS); and a private database to confirm the connection between the physicians and teaching hospitals and the payment information, CMS explained on a press call September 30. Records that were fully confirmed against physician names, national provider identifiers (NPIs) and licenses are published and the physicians are identified; those that were not confirmed have been published without identifying the physician.
Also de-identified are records for which providers entered a dispute in the review period but did not have 45 days to pursue it as the law allows .
Of the unpublished records, 190,000 are not available because the GPOs or manufacturers requested that the information be held for reasons relating to ongoing research, as the law allows, while 9,000 are unpublished because a dispute lodged by a provider is ongoing.
CMS says the agency expects the de-identified 2013 data will be updated during the next reporting cycle in 2015 so that the physicians are identified.
Beware of Big Files
The Open Payments website has a download library and a “data visualization” tool to help you navigate the data — including a search feature for looking for individual doctors or teaching hospitals.
The online files are big. The largest identified data for general payments is 1.4 gigabytes, and CMS warns that you may have trouble importing these large files into regular spreadsheet programs such as Excel.
If you have an IT team, you can use a database server such as MySQL to put the big file into a database and then develop a simple user interface for you to view and work with the files, suggests Sean Vogt, director of operations at Greenview Data in Ann Arbor, Mich. Alternately, you can use a commercial file editor such as Vedit which Greenview developed, to split the files into parts that can fit into Excel, he says.