April 9, 2014
The release of Medicare physician payment data for 2012 represents a watershed moment in transparency in American medicine.
The U-M Medical School’s Faculty Group Practice, and the entire U-M Health System, offer these key points to help members of the press and public understand the data about our providers.
- More than 1,700 U-M Medical School faculty physicians and many other top-level clinicians care for patients at U-M hospitals and health centers, and at the VA Ann Arbor Health Care System. The newly released data includes 2012 billing totals for physicians and other providers who care for Medicare patients, and billed Medicare for a particular type of visit or procedure involving 11 or more patients in that year.
- The U-M Health System and its Faculty Group Practice collect revenues centrally for services provided by our physicians and other providers. The payments listed in the CMS data for our providers were not paid to the individuals themselves.
- U-M faculty physicians and other U-M providers (such as clinical psychologists, audiologists, physician assistants and advanced practice nurses) are all employees of the University and receive a salary. We also base part of our faculty members' salaries on their medical specialty and patient-care productivity..
- Because our specialty providers practice some of the most advanced medicine in the country, and conduct clinical trials of new treatments, our Medicare reimbursement data will reflect this. We care for some of the most complex and critically ill patients in the country, with some of them traveling hundreds or even thousands of miles to receive care here. We also train clinical fellows – physicians in advanced training programs who assist our physicians but cannot bill Medicare directly.
- In all, Medicare payments make up about 22 percent of our clinical business.
- The database lists one of our faculty members, Jean Malouin, M.D., of our Department of Family Medicine, as having Medicare payments of more than $7.58 million for more than 207,000 patients. She directs the MiPCT (Michigan Primary Care Transformation) demonstration project, funded by the Centers for Medicare & Medicaid Services, that works to improve the quality and efficiency of health care for Medicare patients around the state of Michigan.MiPCT involves 400 primary care practices and 1,600 primary care physicians and mid-level providers around the state. As part of the project, each provider receives a small payment per month to support the cost of care managers, extended office hours, and other added services that may ultimately help prevent unnecessary hospitalizations, emergency room visits and other costly care. As Medical Director of MiPCT, these payments flow from CMS to U-M under Dr. Malouin’s name and are immediately paid out to each practice or physician group.
- We work every day to make care for Medicare participants better and more cost-effective – and have done so for more than a decade. We were one of the first physician groups to prove that it’s possible to improve care while holding down costs at the same time, through Medicare demonstration projects that saved tens of millions of taxpayer dollars. Now, we’re leading one of the nation’s largest Medicare Accountable Care Organizations, which is working to improve the quality and efficiency of care for more than 120,000 Michiganders covered by Medicare who receive care from 5,700 doctors and other providers around the state – including our own.
- The health care researchers at our Institute for Healthcare Policy and Innovation are well positioned to analyze the new data for important research on how health care is provided in America. We look forward to sharing their findings.
More on UMHS efforts to improve care for Medicare patients while containing costs