What should patients take away from doctor billing data?

     ProPublica's online tool, Treatment Tracker, gives patients a new view on how their doctor practices medicine. (<a href=Photo via ShutterStock) " title="sschestxrayx1200" width="640" height="360"/>

    ProPublica's online tool, Treatment Tracker, gives patients a new view on how their doctor practices medicine. (Photo via ShutterStock)

    Maybe your neighbor knows a good cardiologist — or your cousin recommends a cancer specialist she loves. That’s all well and good, but lots of patients are looking for more objective, data-driven ways to choose a doctor.

    The online tool Treatment Tracker from the newsroom ProPublica is giving patients a new view on how their doctor practices medicine.

    The widget shows patients if their doctor is ordering medical tests or doing procedures in a way that’s different from his or her peers in the same medical specialty.

    The tool is also being used to sniff out attempts to overcharge the government.

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    “It’s not necessarily fraud but it starts to smell like it,” said health economist Robert Town, a professor at the University of Pennsylvania’s Wharton School.

    “Because someone is an outlier doesn’t mean there’s fraud, I think that’s important to recognize,” he said. “There are always going to be doctors who specialize and take on more severe cases.”

    The tracker culls Medicare billing data. Analysts say a doctor’s billing patterns begin to tell a story about how a physician practices medicine — or maybe suggest that a doctor is ordering unnecessary tests.

    Many patients believe that more health care is better and can even pressure doctors for extra tests or certain treatments. However several studies show that there are serious risks associated with overtreatment.

    There’s a growing call for the government to more closely track how doctors bill Medicare.

    Mark Duggan, professor of Health Care Management at The Wharton School said stepped-up scrutiny could discourage aggressive billing.

    “It makes a lot of sense as a result of the greater ease and the lower cost of analyzing data for the government to telescope in,” Duggan said.

    Even if accountants do not find fraud, Duggan said a closer look at billing could be a good investment of federal dollars.

    “Because providers realize that they are going to be put under the microscope a little more, just in the same way we may hire more police and that may deter crime,” Duggan said.

    As the government considers policy changes that would cut down on wasteful spending, Duggan said it’s important to avoid unintended consequences.

    Duggan said you want to avoid penalizing doctors who take on the most difficult, complex patients — and have legitimate reasons for “outlier” billing patterns.

    “If you are not careful you could end of harming patients’ health,” and reduce the pool of specialist doctors who take on tough cases, Duggan said.

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