Tempest in a teapot or slippery slope? Doctors respond to Medicare data

Posted by: in Analytics, Digital Health, Healthcare Insights, MDigitalLife, Medical Communications, Social Media Insights & Trends on April 12, 2014

Fletch movie image Chevy ChaseThose of you who follow the healthcare industry very closely (and many of you who don’t!) have no doubt been puzzling through the ultimate meaning of Medicare’s “data dump” – a list of nearly every procedure performed by a U.S. doctor on a Medicare patient. For most doctors, the reaction has been fairly muted. As my colleague Brian Reid reported on Tuesday:

 A quick scan late yesterday suggested that there were just over 200 tweets on the topic. And there was nary a peep of protest. The closest anyone came to an “outcry” was Chicago-based primary care doc Atul Jain, who tweeted out: “Transparency + muddied data = confusion.”

Brian Reid, Doctors who tweet aren’t the ones who bill medicare for millions – via KevinMD.com, 4/10/14

And although the response remained fairly muted through Friday, it was clear that there was some growing concern about what the release of that data – in the form that it was, with the (relatively little) context provided – could be problematic. I used our MDigitalLife database* to dig a little deeper into what doctors were reading and sharing relative to the announcement.

First of all, it’s no surprise that conversation volume was much higher than normal. For the 3 day period we studied (4/9-11/2014), the volume on our keywords** was 600% higher than for the same period in the prior week. Perhaps more importantly, the number of doctors participating in that conversation increased nearly as much, with 419% more doctors engaged this week.

There was a significant amount of retweeting activity (unsurprising for a news-heavy topic like this one), with the most-retweeted handles being Kaiser Health News’ Jordan Rau, WSJ Editor Gerard Baker, Vox Senior Editor Sarah Kliff, Electrophysiologist Dr. John Mandrola and health data guru Fred Trotter. Interestingly, even though the media clearly dominated the top of the list, doctors owned the long tail. Here’s a breakdown of the top 25 most-retweeted accounts:

The tone of the conversation began to migrate as well. When performing a content gap analysis*** on the data from this week as opposed to last week, there were some interesting changes.

  • Last week’s differentiating words included: Public, see, good and care
  • This week’s included: Transparency, payment, biller, payout, opthamology, disclose and mislead

The last, of course, is the most telling; it will be interesting to see where physicians’ public dialog goes.

One of the most interesting things about studying physicians’ online dialog is to see what they’re reading –  and subsequently find worthy of sharing. Between Wednesday and Friday this week, US doctors shared more than 50 separate articles; here are the ones they shared most, in order:

  1. New York Times – Sliver of Medicare Doctors Get Big Share of Payouts, Reed Abelson and Sarah Cohen
  2. Wall Street Journal – Small Slice of Doctors Account for Big Chunk of Medicare Costs, Christopher Weaver, Tom McGinty and Louise Radnofsky
  3. New York Times – How Much Medicare Pays For Your Doctor’s Care
  4. KevinMD – Doctors who tweet aren’t ones who bill Medicare for millions, WCG’s Brian Reid
  5. Washington Post – The top 10 Medicare billers explain why they charged $121M in one year, Jason Millman
  6. CMS – Medicare Provider Utilization and Payment Data: Physician and Other Supplier
  7. Washington Post – Data uncover nation’s top Medicare billers, Peter Whoriskey, Dan Keating and Lena K. Sun
  8. (Tie)

[NOTE: There’s no small amount of pride to see my colleague Brian Reid coming in at number 4 on that list – pretty amazing validation of the interest that physicians have in the work that we’re doing]

There has also been some really excellent physician journalism on the subject; here’s a smattering of some of my favorites:

From Leslie Kernisan, MD: “Why Patients Should Care About Doctors & Money” ( @GeriTechBlog)

From John Mandrola, MD: Six initial impressions of the Medicare payment disclosure story  (@drjohnm)


And although not from a physician blogger, I wanted to give a shout-out to Chris Hogg for sharing this excellent work from the team at Practice Fusion: PracticeFusion doctors received more than $5B in Medicare payments in 2012  (@CWHogg)

Finally, although it went to press too late to be considered for this analysis, I’d definitely encourage you to look at Brian Reid’s follow-up piece on this blog, exploring a fascinating aspect of the Medicare data that seems to have gone completely unnoticed: There are almost no women in the list of top billers.

Medicare’s Top Billers: Where are the Women? by Brian Reid

*We’ve indexed the digital footprint for over 200,000 US physicians to date – MDigitalLife is the world’s the first and only data set to link physicians’ digital properties to a national physician registry

** Keywords: CMS OR #CMS OR CMMS OR #CMMS OR Medicare OR #Medicare OR “data drop”

*** A content gap analysis compares two sets of text, and looks for the words and phrases that appear either MUCH MORE or MUCH LESS than in the opposing document [NOTE: Vast oversimplification; ask your friendly neighborhood statistician for details]

By: Greg Matthews

Greg Matthews is the the creator and Managing Director of the W2O Group's MDigitalLife - Understanding, Engaging and Activating Physicians in the Digital Age

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