Payment Program Posts 2015 Financial Data

June 30, 2016

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CMS’ Open Payments Program Posts 2015 Financial Data

Health care industry manufacturers reported $7.52 billion in payments and ownership and investment interests to physicians and teaching hospitals in 2015

Today, the Centers for Medicare & Medicaid Services (CMS) published the 2015 Open Payments (sometimes called the “Sunshine Act”) data, along with newly submitted and updated payment records for 2013 and 2014, at https://openpaymentsdata.cms.gov/.  The Open Payments program requires that transfers of value by drug, device, biological, and medical supply manufacturers to physicians and teaching hospitals be published on a public website.

In program year 2015, health care industry manufacturers reported $7.52 billion in payments and ownership and investment interests to physicians and teaching hospitals. This amount is comprised of 11.90 million total records attributable to 618,931 physicians and 1,116 teaching hospitals. Payments in the three major reporting categories are:

  • $2.60 billion in general (i.e., non-research related) payments
  • $3.89 billion in research payments
  • $1.03 billion of ownership or investment interests held by physicians or their immediate family members

Over the course of the Open Payments program since 2014, we have published 28.22 million records, accounting for $16.77 billion in payments and ownership and investment interests.

The Open Payments 2015 program year data set is the second full year of data available on the CMS Open Payments website. The availability of consecutive, full-year data provides for the opportunity to now trend the health care industry’s payments to physicians and teaching hospitals for items and services such as food and beverage, travel, education, honoraria, and research.  We are also able to analyze payments related to covered drugs, devices, biologicals, and supplies.  For example, we were able to determine that for program year 2015, 2.26 percent (637,131 records) of all financial transactions between physicians and pharmaceutical companies were related to opioid medications.

The amount and distribution of payments and ownership and investment interest categories remained consistent between 2014 and 2015.  Table 1 below compares 2014 and 2015 payments by category – general, research and ownership and investment interests.

Table 1

While totals by major reporting category remained relatively unchanged between 2014 and 2015, there were some shifts in who was paid and how the money was spent.  See Table 2 and Figure 1 below. The Open Payments program does not distinguish between payments that are beneficial and those that may indicate conflicts of interest; however, the identification of these shifts may be of significance to researchers and other interested stakeholders.

Table 2Table 3Table 4

Health care industry manufacturers must report to the Open Payments program annually, while participation by physicians and teaching hospitals is voluntary and encouraged. If physicians or teaching hospitals disagree with what has been reported about them, they can initiate a data dispute against the record and work with the reporting entity to resolve the discrepancy before the data is published. This process helps verify the accuracy of the Open Payments data. Overall, 0.13 percent of records (16,653 records) were disputed, accounting for 1.95 percent of the total value of published records.  Additionally, 0.22 percent of records (28,955 records) were affirmed by physicians and teaching hospitals, accounting for 0.76 percent of the total value of the published records.  Registeredphysicians and teaching hospitals with data attributed to them in the Open Payments system account for 35.45 percent of the total value of their published data. This does not include research-related payments made to non-covered recipients that employed physician principal investigators, which accounted for 40.92 percent of the published payments value.

Acting CMS Administrator, Andy Slavitt, highlights the importance of the Open Payments program in furthering CMS’ commitment to transparency:

“Open Payments is a trusted consumer resource that provides consumers and other interested stakeholders with data about the financial relationships between physicians and health care industry manufacturers.  This transparency, along with our other transparency programs, helps further our mission of achieving a high-quality health care system that ensures better care, access to coverage and improved health at lower cost.”

Dr. Shantanu Agrawal, CMS Deputy Administrator and Director of the Agency’s Center for Program Integrity, added that “transparency is empowering physicians to be purposeful about their financial relationships with companies, and there is a notable shift towards charitable contributions and away from other interactions such as honoraria and gifts.”

CMS has also implemented several enhancements to the public Open Payments program website. For example, search results will now be aggregated in alphabetical order by company reporting the payment. Dr. Agrawal,  emphasizes that these improvements will improve clarity of the data and enhance the user experience:

“The recent enhancements to the Open Payments website helps provide data to the public in a way that is easy to search, analyze, and download,” Dr. Agrawal said.  “These improvements will help the user to more easily access and examine data related to the financial relationships between manufacturers and health care providers.”

CMS is scheduled to refresh the Open Payments data in early 2017 to reflect updates to the data that have been made since this publication. For more information, please visit: https://www.cms.gov/openpayments/index.html and https://openpaymentsdata.cms.gov.

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