For a moment there, it looked like a point-counterpoint clash of health-policy views, based on this post: Deluge of Medicare data: Is it useful? Well it’s a step.
Dr. Darshak Sanghavi, a distinguished Massachusetts-based doctor/author who is now a fellow at the Engelberg Center for Health Care Reform at the Brookings Institution, tweeted that he was “not on board with that view.” (The view that the great recent gush of Medicare data is not very useful. At this point, anyway.)
Turns out, though, that Dr. Sanghavi is quite willing to stipulate that, as he put it when we spoke today, “It is highly unlikely that the average patient can do much with Excel spreadsheets containing millions of line items with medical codes.” So from the patient’s point of view — our usual CommonHealth vantage point — he agrees.
But he adds a big “however.”
“However, having said that, I think part of the challenge now is: What should people who have data-crunching skills — whether private industry, regulators, government officials and others — now that the data is out there, what business case can be made for them to do that work for you?”
“I think the key consumer here is not the patient — tens of millions of spreadsheet entries are not going to be valuable to patients. But this is exceedingly valuable to insurers now. Insurers know what their claims are now, but there’s a very competitive insurance marketplace. As an insurer you only know, say, your 5 or 10 percent of the market, but now that you have Medicare data, you can say, ‘That’s really weird. On Medicare patients, they’re only doing steroid injections on one patient out of 10 or whatever, whereas on my covered patients, they’re doing it on 50 percent. Why is that? Is it because I’m paying a different rate than Medicare? Are my incentives screwed up? Should I be rethinking how I do pricing and contracting? Or is there some really good reason?’ You can see what is price-sensitive behavior on the part of providers in a way you couldn’t see before. So that’s very valuable, if you’re a private insurer.
“Now suppose you’re a public health researcher. Continue reading