How To Find Amazing Medical Market Statistics on Physician Activities and Reimbursement

6 Min Read

I am an information geek

Not many people know this about me, but I took my first steps in the life sciences industry 14 years ago by working as an analyst for a life-sciences venture capital firm (well, Manager of Deal-Flow and Market Analysis to be exact).

Since then I diversified to business development and marketing for medical companies, which culminated when I established CadenSee—Let’s Talk Medical.

I am an information geek

Not many people know this about me, but I took my first steps in the life sciences industry 14 years ago by working as an analyst for a life-sciences venture capital firm (well, Manager of Deal-Flow and Market Analysis to be exact).

Since then I diversified to business development and marketing for medical companies, which culminated when I established CadenSee—Let’s Talk Medical.

Despite the fact that CadenSee specializes in communication, I am always happy to help clients with their questions about getting information for market research, business plans, and so forth.

I am an information geek. What can I say?

So I’ve decided to share with you a few really good resources for finding medical market statistics that you can use for any purpose:

  • Locate high-volume users to plan your U.S. marketing-penetration study of sales
  • Find key information for your market analysis.
  • Identify trends and usage patterns or medical procedures

These are amazing. But keep in mind that just two out of the three are updated to 2012.

Get comprehensive inpatient information (from providers to reimbursement) via the Health Care and Utilization Project

The Healthcare Cost and Utilization Project  (HCUP) is the most comprehensive source of hospital data in the United States. The information provided in the database includes information on in-patient care, ambulatory care, and emergency department visits.

The HCUP is not a single database but a family of databases that are derived from administrative data and contain encounter-level, clinical and nonclinical information, including all listed diagnoses and procedures, discharge status, patient demographics, and charges for all patients, regardless of payer (e.g., Medicare, Medicaid, private insurance, uninsured), beginning in 1988.

HCUP enables researchers, insurers, policymakers, and others to study health care delivery and patient outcomes over time, and at the national, regional, state, and community levels.

All you need to do to search this database is to insert the procedure (diagnostic or surgery) procedure code number (ICD9) and you can get information on hospitalization, discharges, length of stay, payer, patient gender, and more.

So if you are working on a business plan or conducting market research for the launch of your medical device, you can receive accurate per-state information on actual cases. If the facts you need are among those available, these are more accurate than purchasing research off the shelf.

Get inpatient information on HCUPNet

Find which physicians are on the payroll of medical device and pharma companies, thanks to Open Payments database

Open Payments is a federal program that collects and makes public information about financial relationships between the health care industry, physicians, and teaching hospitals. It took years to obtain and release this data and the information provides insights about the financial relationships between industry and health care providers.

The Open Payment database is run through the Centers for Medicare & Medicaid Services (CMS), which collect information from medical-device manufacturers and pharmaceutical manufacturers about the payments they make to physicians and teaching hospitals.

It contains data from more than 1,000 companies. Did you know that Gilead paid Dr. Ramesh Kalari from Indiana 8 cents for food and beverage? It is that accurate.

https://openpaymentsdata.cms.gov/

Get perfect statistics and information on outpatient visits by physician and other providers

This is probably one of the most amazing medical marketing and sales planning tools out there. It is a marketing manager’s dream.

The Centers for Medicare & Medicaid Services (CMS) has prepared a public data set called the Medicare Provider Utilization and Payment Data: Physician and Other Supplier Public Use File. The file contains comprehensive information on services and procedures provided to Medicare beneficiaries by physicians and other healthcare professionals. The Physician and Other providers contains information on:

  • Utilization
  • Payment (allowed amount and Medicare payment)
  • Submitted charges organized by National Provider Identifier (NPI), Healthcare Common Procedure Coding System (HCPCS) code
  • Place of service (physician’s name and address)

It is based on information from CMS’s National Claims History Standard Analytic Files. The current database covers 2012 and contains 100% final-action physician/supplier Part B non-institutional line items for the Medicare fee-for-service population.

To use it, you need to download the datasheet, which contains more than a million records. Then sort it by CPT code, state or any other way you see fit. You’ll receive the precise number of outpatient procedures a physician has conducted (under Medicare).

Go to download the comprehensive datasheet

I figure that if I’d be happy to help my clients find these sources, I ought to share them with you, too!

Do you have anything medical market statistics to share?

Image via Shutterstock

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