Court Rules Medicare Must Make Doctor Performance Data Public

In a little-noticed but historic ruling, a court has ordered Medicare to open its books so that beneficiaries can evaluate the performance of a doctor they are considering, much as they might check on an airline's on-time record.

U.S. District Judge Emmet G. Sullivan ruled that Consumers' Checkbook, a non-profit group, may have access to a vast database of Medicare records that track procedures performed by doctors. Up to now, the database has been inaccessible to Medicare recipients due to a government policy that sought to protect doctors' privacy. The ruling does not apply to any data on patients.

With access to the Medicare database, beneficiaries will be able to see, for example, how many times a year a surgeon has performed a specific procedure, the way a particular doctor balances quality and costs when it comes to certain procedures and tests, and which doctors seem to order unneeded tests or hospital visits.

Doctors say that Medicare's data does not account for the fact that some doctors take on sicker patients. "Physicians are concerned that they will look bad, not because of their own shortcomings, but because their patients are difficult," Paul Ginsburg, president of the Center for Studying Health System Change, told the Los Angeles Times.

The ruling gives Consumer's Checkbook access only to data on procedures performed by doctors in Washington, D.C., Illinois, Maryland, Virginia and Washington State, but the group has filed a Freedom of Information request for the other states' Medicare information. Once it has data from all 50 states, it plans to make the information available online within a few months, free of charge.

The Bush administration is considering appealing the ruling, but an appeal could be politically embarrassing because President Bush and Health and Human Services Secretary Mike Leavitt both contend the solution to the health care crisis is for patients to be better consumers.

To read the article in the Los Angeles Times, click here.

To read the full text of the court decision, CCS v. U.S. Department of Health and Human Services (D.C., No. 06-2201 (EGS), Aug. 22, 2007), click here.