Open Payments - A critical cog that ties Healthcare manufacturers with providers

Open Payments houses a publicly accessible database of payments that reporting entities, including drug and medical device companies, make to cover recipients like physicians. The motive is to promote a more transparent and accountable health care system. However, if you roll back a decade, there were several differences observed in the way individual payments and cumulative payments were made and reported. There was a critical need for extensive payment reporting rules to be in place. This led to the Sunshine Act 2011. The reported payments include the General, Research and Ownership payments. The Open payments data has shown different trends over the years, not only in terms of the form of payments but also the physicians speciality. In this blog, we tried to have a closer look at the general payment trends from 2019 CMS data.

Note: Following Visuals cover the data from the CMS open payments data 2019 https://www.cms.gov/openpayments for General Payments Only specific to the US.

The below graphs will help gain a closer look at open payments data for the Year 2019:

1. Top 10 Physician Specialities by Payments

The above treemap shows the distribution of payments made into specific physician speciality areas.
- It is clearly visible that Internal Medicine accounts for the maximum percentage of total payments made (32.65%) followed by Orthopaedic Surgery (29.80%).
- One important thing to notice is that there is a huge difference between payments made to the Top-2 specialities and the specialities below them.

This suggests that Internal Medicine and Orthopaedic Surgery are the most paid specialities at the current time.

2. Distribution Of Payments By Nature

The above Pie Chart Shows the Distribution of the payments by nature of payments or transfer of value.
- It is evident that the majority of the payments were made for royalty and License(44.31%) followed by Compensation for services(18.79%) and Consulting fees(12.81%).
- This is the distribution for all the payments. However, fiddling around with the combination of slicers provided can give us a clearer picture specific to Teaching Hospitals or Physicians, State, Speciality and the form of payment used.

3. Total Payments by Months

The above area chart shows the monthly payments done to various physicians and teaching hospitals.
- There is some similarity in the payment trends for both entities. However, there is a significant spike once every quarter, probably signifying bulk payments are separated out evenly across the year. These are mostly the mid-quarter months ( May, Aug, Nov).
- We can also see a major uptick in January. The high volume of payments this month indicates upfront payments at the beginning of the year, maybe as a part of budgeting cycles to cover round-the-year payments.

4. Top 10 States By Average Pay

The above graph shows the top 10 states by average pay.
- Despite receiving the maximum payments in a year, California(CA), the largest state in the US, lags behind in the average pay.
- Massachusetts(MA) tops the table with an average payment of $2402.89.This indicates the number of recipients(Physicians and Teaching hospitals) to total Payments ratio is the highest in MA compared to other states.

The above numbers represent all the payments; however, they may look different when we look at physicians and specialities or Teaching Hospitals.

5. Top Spending GPO

The above chart shows the Top - 10 payment-making Manufacturers or GPOs. Genentech Inc leads the overall list when we look at holistic data that accounts for all specialities and states. However, it would be interesting to see how the picture looks upon playing with different combinations using the help of provided filters.

Conclusion

On analysing the 2019 CMS Open payments data, we conclude that Internal medicine stands out as the highest-paid speciality of all. Also Genentech.INC tops the list of GPOs making payments. Most of the payments were made for Royalty and Licence. When considering the average pay Massachusetts(MA) tops the list, although 7th Smallest state in the US.