Better Medical Marketing with the New (and Free) Medicare Data Set of 880,000 Providers

April 19, 2014
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Medicare data set for medical marketers

Medicare data set for medical marketers

In 2012, 880,000 physicians and providers billed a total of $77 billion

The U.S. medical market has been in turmoil since the U.S. Centers for Medicare and Medicaid Services released a comprehensive data set including all of the $77 billion in Medicare payments paid to over 880,000 physicians in 2012. The current data set covers only 2012 payments for Medicare Part B, which covers doctor visits, tests, and other treatments.

The objective of this release is increased transparency of the healthcare system. Finally, everyone can see what doctors are charging and what they are being paid by the government.

Find out what each doctor billed Medicare for and what he or she was paid

What is amazing about this data set (which runs to almost 400MB) is that it identifies by name every physician or provider reimbursed by Medicare, as well as the amount reimbursed and the service or procedure paid for. The following information is included for each physician or provider:

  • Name
  • Address
  • Gender
  • Specialty
  • Place of service
  • Billed Codes (HCPCS)
  • Number of patient (per service/procedure)
  • Average billed
  • Average reimbursed

It is truly the most comprehensive information available about Medicare claims and payments.

Remember: Reimbursement does not equal profit

The Medicare data set includes a lot of useful information, but it can be confusing. What do these numbers actually mean? Well, for starters, it’s important to remember that reimbursements aren’t profit. The information here captures only what physicians were paid for services they provided. A large portion of the reimbursed amounts cover expenses incurred by the physician such as overhead, staff salaries and drug costs. The Washington Post estimates that, on average, 43% of payments go to office overhead expenses, 13% to drugs, and 3% to malpractice premiums, leaving 41% to cover the doctor’s compensation.

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An amazing source for medical marketers is just a click away

This Medicare data set is potentially a godsend for medical marketers looking to plan and execute more targeted marketing strategies. This information could enable you to communicate more effectively with your target audience and optimize resources. Here are a few ideas for using the Medicare and Medicaid Services data set. How you segment the data and what you get out of it will depend on your strategy, as well as the value and benefits of your medical device:

1. Find the largest providers and help them increase their margins

You can instantly identify the physicians and clinics who could potentially be your clients. If you can show these physicians that your medical device is more cost-effective than what they’re using, either because it’s less expensive or because it’s easier to use, they may replace their existing technology with your product —increasing their profits.

2. Find the smaller providers and help them grow

Your product might be a revenue generator for physicians who provide a small number of treatments or tests, offering them a solution to grow. This could be especially useful if your device is affordable and can show a quick ROI compared to the alternatives on the market.

3. Find new markets for your medical device

Does your medical device complement a product that is routinely used in clinical practice? Look for providers who offer the complementary solution and might be sending patients to other facilities for additional testing and treatment, thereby losing income.

4. Identify early adopters for your device

You might be looking for key opinion leaders who can provide early feedback about how your device performs in use. The Medicare data set is an ideal tool to locate physicians who represent your target demographic.

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5. Find physicians for market research

One of the most difficult elements of any product launch is finding the audience that can give you feedback you can act on. With the Medicare data set, you can easily segment the data to find your demographic. You can then contact physicians or providers who fit your preferred profile to participate in a phone survey or focus group.

The bottom line: the data set can help you improve planning and optimize resources

You can segment the Medicare data set in so many different ways. It can help you optimize resources demographically (targeting the right group of physicians) or geographically (targeting the right locations). While the entire Medicare and Medicaid data set is downloadable to an Excel spreadsheet that can be filtered and sorted according to your needs, there is another way to quickly view the data: the New York Times Tool. The tool is far more limited in the capabilities it provides to support more sophisticated medical marketing planning, but it might be a good place to start. Question: How would you use this data set?

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