Understanding CMS' Open Payments Portal

Last week, I gave my opinion about CMS' Open Payments Portal. Here's some details on how it works so you can make your own verdict.

Sometimes, doctors and hospitals have financial relationships with healthcare manufacturing companies. These relationships can include money for research activities, gifts, speaking fees, meals, or travel. The Social Security Act requires CMS to collect information from applicable manufacturers and group purchasing organizations (GPOs) in order to report information about their financial relationships with physicians and hospitals. Open Payments is the federally run program that collects the information about these financial relationships.

The information is being made public under a provision of the Affordable Care Act that mandates disclosure of payments to doctors, dentists, chiropractors, podiatrists, and optometrists for things like promotional speaking, consulting, meals, educational items, and research. CMS opened its Open Payments website on Sept. 30.

According to the government, Open Payments is supposed to provide the public more information about the financial relationships between physicians and teaching hospitals and applicable manufacturers and GPOs.

Specifically, according to CMS, the program:

• Encourages transparency about these financial ties;

• Provides information on the nature and extent of the relationships;

• Helps to identify relationships that can both lead to the development of beneficial new technologies and wasteful healthcare spending; and

• Helps to prevent inappropriate influence on research, education, and clinical decision making.

For physicians and teaching hospital representatives, a "data-in context page" allows you to review the data reported about you in the Open Payments system so you can ensure that this information is accurate. You can also:

• Download a free mobile app to help track financial interactions and assess the accuracy of reported information; and

• Use the information reported about them to plan for questions from patients.

According to The Washington Post, the value of payments totaled $3.5 billion in the reporting period from August 2013 to December 2013. The massive data compilation revealed details of the amounts paid, including travel destinations, of 546,000 clinicians and 1,360 teaching hospitals receiving benefits.

According to NPR, Pfizer made payments to 142,600 doctors, AstroZenica 111,200, and Johnson & Johnson made payments to 97,000 doctors. There are an estimated 800,000 to 900,000 active doctors in the United States.

The Open Payments or “Sunshine Act” is designed to prey on the ancient physician prejudice that earning money is somehow beneath the profession, much like physician advertising was once taboo and frowned upon by the old guard. Now drug manufacturers must report money paid to physicians and certain hospitals for research studies? Where do we think the $800 million price tag for FDA drug approval goes?

In my estimation, this program is going to worry quite a few physicians, and absolutely no one else. Patients generally like their doctors and want them to do well and be happy. The public, by contrast, is generally not sensitive to even insanely wasteful practices. As an example, it would perhaps be more helpful to remind the nation that the statute creating Medicare Part D contains a provision forbidding CMS from seeking much needed volume discounts from drug manufacturers. This provision actually wastes hundreds of millions of Medicare dollars, in the difference in the prices paid by Medicare versus the Veterans Administration. No one cares.

I would be very surprised if the Open Payments portal has any greater impact.