Release of CMS Medicare Payment Data a Sunshine Dress Rehearsal

There were two major healthcare stories last week.  One involved the announcement that Health and Human Services Secretary Kathleen Sebelius would be leaving and the nomination by President Obama of Office of Management and Budget Director Sylvia Mathews Burwell to replace her.  But also last week CMS made an unprecedented release of Medicare payments data.  For the first time since 1979, the public had access to information regarding which physicians received what kind of sums under Medicare. Media stories were extensive and primarily focused on the amounts of money that went to providers.

For some time now, preparation has been underway for full implementation of The Sunshine Act, incorporated into the provisions of the Affordable Care Act.  Under that law, there will be a similar release of information, only this will focus on payments made from the pharmaceutical, biotech, and medical devices industries to physicians and teaching hospitals.  CMS has been in the process of implementation of the Sunshine Act for some time now and the culmination will be in the first scheduled publication set for the end of September, 2014.

There were many angles to the CMS story to explore in the stories.  But perhaps one of the most important aspects of CMS Medicare announcement for the medical products industry is the fact that it served as a media “dress rehearsal” for the publication of data under the Sunshine Act provisions later this year.

Coverage of the CMS news was broad – spanning many national outlets.  It was both a national story with headlines focused on the top grossing physicians as well as those specialties that saw the highest payments, and a regional one – where local physicians were assessed as seen in this piece from Arkansas Business.

The primary focus was squarely on the amounts of money received by physicians. While many reports carried caution that the whole story did not end there – that there were reasons behind the numbers – the fact that large amounts went to a small group of physicians stood out.  Beyond the individual physicians, there were reports profiling particular physician specialities – oncologists for example.  Some of the messaging around the “behind the numbers” issue worked, some of it did not.  That is something to look at.

There is every reason for one to expect the same type of coverage for the release of information under the Sunshine Act coming in the autumn of 2014.  Again, a good deal of the focus will likely be on the numbers, and there will be some additional messaging about the story beyond the numbers, but the stakeholders may be broader.

First, of course, will be individual physicians who will see a focus on amounts they received.  Second will be the medical societies of particular physician practices where there may have been more interaction with industry than others.  And third will be industry with a focus on everything from comparative amounts expended to exploration of the relationships between the funding and product marketing.

In the field of issues management, it is rare that one gets the opportunity to look at a blueprint and to have the luxury of time to develop messaging ahead of an event. This is one of those rare times.

On their websites, many medical societies have given members overviews and tools to learn about how the Sunshine Act works.  But it may also benefit the membership to have a framework for how to talk about their participation in various industry programs once it is released. There is a story beyond numbers. Members may also face regional stories if they stand out in a particular region or state.  A webinar on the topic may for members might benefit many.

Similarly, industry has been working to aggregate and submit data – it is also time for companies and their trade organizations to examine the coverage from this release of data with an eye for preparation:

  • Begin with both messaging and strategy regarding the release of numbers, decide what worked, what didn’t.  What is the story beyond the numbers?
  • What does it mean to sit on an advisory board?  What are the benefits to patients from the relationships that are developed with physicians?
  • And, given the benefit of time for planning, in addition to preparing for responding to inquiries, stakeholders need to assess to what extent some proactive efforts might be a good idea.

There is a good deal of time between now and the time the Sunshine data is released. Developing and assessing messaging now – considering strategy and possible tactical execution – is probably time and effort well spent.  In the end, preparation will not do away with the negative connotation associated with money, but it can help to paint more of the background picture so that there is greater context associated with the coverage of the release of data.

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