The government has made available to the public significant provider and physician specific Medicare utilization data. Today the U.S. Department of Health and Human Services Centers for Medicare and Medicaid Services (CMS) announced the public availability of a Physician and Other Supplier Public Use File (PUF), which includes data on payment, submitted charges, and services and procedures provided by physicians and other health care professionals to Medicare fee-for-service beneficiaries.

According to Jonathan Blum, CMS Principal Deputy Administrator, the PUF includes over nine million rows of data on more than 880,000 physicians and other health care professionals in all 50 states, the District of Columbia, and Puerto Rico providing care to Medicare Part B beneficiaries in calendar year 2012.

Specifically, the PUF data set includes data on (1) utilization; (2) payment (allowed amount and Medicare payment); and (3) submitted changes organized by National Provider Identifier (NPI), Healthcare Common Procedure Coding System (HCPCS) code, and place of service. The PUF includes the number of services, average submitted charges, average allowed amount, average Medicare payment, and a count of unique beneficiaries treated. CMS notes that, in order to protect beneficiary privacy, it will redact any data in cases of fewer than 11 beneficiaries.

CMS has made the data available in two formats (tab delimited format which requires importing the data into a database or statistical software and excel). CMS has also created a methodology document outlining limitations of data usage as well as summary tables with aggregated information by physician/supplier and State and HCPCS code.

CMS notes that the release of the data is part of efforts to make the health care system more transparent, affordable, and accountable. Previously, a permanent injunction prevented CMS from releasing this type of data. However, according to CMS, a May 2013 court decision vacating the injunction triggered a series of events leading to a policy change, outlined here.

While the public availability of this data will provide payers, providers, consumers, and other stakeholders with an extraordinary amount of new information with which to assess and compare providers and services like never before, use of the data must take into account its limitations. For example, the data does not include providers’ non-Medicare Part B practice, including Medicare Advantage, commercial insurance, and uninsured populations. In addition, the PUF is raw claims data that does not indicate quality of care and is not risk adjusted to taking into account differing levels of severity.

For more on the PUF, see Jonathan Blum’s blog post here and CMS’s press release here.