New transparency in Medicare payouts

Federal officials released a huge trove of data Wednesday that show what Medicare has paid to more than 880,000 doctors and other health care providers nationwide. There were some eye-popping stats:

• About 2 percent of doctors collected about a quarter of the $77 billion in payments in 2012.

• An ophthalmologist in West Palm Beach, Fla., topped the list by raking in more than $26 million to treat fewer than 900 patients. That is 61 times the average Medicare payout of $430,000 for an ophthalmologist.

• A Florida cardiologist earned $23 million in Medicare payments, nearly 80 times the average for that specialty.

Those numbers no doubt shocked a lot of Americans. It was news to them. It was not news to Medicare officials, though. They've had this information all along.

Medicare, the federal health care system for the aged that spends more than $500 billion a year, faces an uncertain future. It desperately needs to be more efficient. The data released Wednesday suggest this system has a long, long way to go to control its costs.

High Medicare payments to particular doctors or institutions are not by definition signs of waste or fraud. Some doctors justifiably earn more because they're trained in certain specialties. Some treat patients who require more constant care. There are major regional variations in how doctors practice.

The release of this data is an important step toward that goal. For the first time, Americans can see what individual doctors charged, and what Medicare paid, for thousands of services and procedures. Doctors who bill Medicare for performing more procedures than reasonably could be accomplished in a day face greater odds that they'll be questioned. The same goes for doctors who overtreat patients by ordering extraordinary numbers of tests or who treat a suspiciously high number of patients diagnosed with extremely rare conditions.