CMS release of physician data illustrate challenges of health care

In early April, CMS released data on the reimbursement Medicare paid to individual physicians. The data and its release provide a great illustration of one of the challenges of health care. It is risky to trust data, and it is risky to dismiss it. There is another risk of data — sometimes its existence can change behavior. This may seem counter-intuitive, but sometimes data can actually increase the risk of a compliance problem.

Data analysis tends to encourage people to make sure that they look “normal” or “typical” to a reviewer. While that effort will often benefit the compliance process, there are many times that accurate coding will yield “atypical” data. If an organization attempts to mechanically shift coding so that the results look normal, there is a real risk that can result in inaccurate coding/billing.

To read the full blog by David M. Glaser, JD, click here.