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Tip Sheets

The new ecosystem of health data keeps getting bigger

By Charlie Ornstein, ProPublica
charles.ornstein@propublica.org
@charlesornstein

Each year, the release of new datasets makes it more exciting to cover health care. No longer are we limited to comparing states to one another to look for differences. No longer are doctors’ practice patterns protected by outdated privacy rules. We have entered an era in which we can compare one doctor to another. And what we’re learning is that there are huge, seemingly unexplainable, differences among them.

This tip sheet offers both very broad data sources, as well as more granular ones. None of the data sets cover individual claims-level data, which require special permissions and often cost a lot of money.

Medicare and Medicaid Statistics: Top level, super useful. Last released: August 2014. Released annually. Additional summary data and charts can be found. In all cases, there is a data lag of at least a year.

Geographic variation: How Medicare utilization differs from state to state and from county to county. Data is available from 2007 to 2013. This will help put other data sets in context. Last released: February 2015. Released annually.

How much doctors are paid by Medicare and what they do for that money:  This page includes links for inpatient hospital stays, outpatient hospital visits and services provided by doctors/other health providers. ProPublica has created a nice visualization for each provider. Last released: April 2014; covers the year 2012. Hopefully will be released annually. (Important caveat with this data: It only contains claims for services rendered in Medicare fee-for-service, not for those in Medicare Advantage. As a result, it will leave out lots of services delivered in regions of the country where Medicare HMO enrollment is high, and thus may not be representative.)

What drugs doctors prescribe most: For now, CMS hasn’t officially released prescribing data from Medicare Part D, but ProPublica has filed Freedom of Information Act requests for it and has put the data online for free. See our app or look up Medicaid utilization data as well (but this is summarized by state, not by doctor). Last released: July 2014 (covers the year 2012). Hopefully will be released annually. This accounts for all prescriptions covered in Medicare Part D, but it’s important to note that not every Medicare recipient is enrolled in Part D. Also, data is redacted when a doctor prescribed fewer than 11 prescriptions for a particular drug.

Who doctors refer patients to: Health care data guru Fred Trotter of DocGraph has requested so-called referral data from CMS for a few years now under FOIA. The agency has posted it online in a hidden corner. Again, data is redacted when the cell size is less than 11.

What incentive payments doctors have received for using electronic medical records:  Updated monthly.

Doctor addresses and specialties: These are part of the National Provider Identifier system, updated weekly/monthly, based on health professionals’ self-reported information. Download the file here. Link to download is at the bottom of the page. See an open-source API or the GitHub link. Physician Compare has additional information on doctors who participate in Medicare. NPI data updated monthly. Physician Compare data last updated in February.

Pharma/device company payments to doctors: Data for the last five months of 2013 (about 40% of payments are redacted) is available. If you are willing to wait until June, you’ll get unredacted 2013 data and complete year 2014 data. Subsequent years’ data will be released every June after the close of the year. Note: ALL drug and medical device companies were required to report such payments beginning last year; ProPublica has data from companies that were required to do so earlier because of corporate integrity agreements.

Quality measures: Data: Medicare.gov includes information about hospitals, nursing homes, doctors, dialysis facilities and home health care companies. Data includes demographic information (names, addresses, phone numbers), as well as quality and satisfaction measures. ProPublica used the emergency room quality measures to power its ER Wait Watcher app.

Hospital inspection reports: The federal government has also started making available online its deficiency reports for health facilities. It currently does so for nursing homes (scroll down under “related links”)  and for hospitals (scroll down to downloads). The Association of Health Care Journalists makes hospital inspection reports available in an easy-to-use interface, and ProPublica does the same for nursing home reports. Nursing home inspection reports are updated monthly; hospitals quarterly.

Custom calculations: Use this link to estimate Medicare cohorts for diseases, etc.

Sign up for email updates from CMS on new data and updated data: CMS’ chief data officer Niall Brennan (@n_brennan) has advocated for greater data transparency in the agency.

Other health agencies

Drug side effects: Now available on the OpenFDA, along with other public use files from the agency. Check out ResearchAE to look at how this data can be visualized.

Doctor discipline: The Health Resources and Services Administration has summary data by state and profession and year on doctor discipline, as well as malpractice payouts.

Centers for Disease Control and Prevention