If you’ve ever left a doctor’s office feeling confused over why they prescribed you a certain medication, your confusion may be linked to something bigger. Did you know that prescribers (doctors, NPs, PAs, etc.) are legally allowed to accept money and gifts in exchange for prescribing certain medications? In recent years, there’s been increased scrutiny on the financial relationships between healthcare providers and pharmaceutical companies. The Physician Payments Sunshine Act, part of the Affordable Care Act, mandates transparency by requiring companies to disclose payments, gifts, and other items of value given to healthcare professionals.
For therapy clients who've interacted with prescribers, understanding the financial dynamics within the healthcare system can be a game-changer. Enter OpenPaymentsData.cms.gov – an invaluable resource that opens a window into the financial relationships between healthcare providers and pharmaceutical or medical device companies. In this article, you’ll learn all about Open Payments and how it can help you be a more empowered and knowledgeable patient.
The Basics: What and Why
At its core, OpenPaymentsData.cms.gov is a transparent database that discloses financial relationships between healthcare providers, including prescribers, and various industry entities. But why does this matter to you, the therapy client? The answer lies in the ability to make informed decisions about your treatment, ensuring you actively participate in your healthcare journey.
Here’s a Step-by-Step guide on how to navigate the website:
Visit the Website: Start by accessing OpenPaymentsData.cms.gov. At the time that this article was written, data was available through the year 2022.
Search for Your Prescriber: Utilize the search function to find your prescriber. Filter results by entering their name, location, or other relevant details. I recommend searching by just their name and state. If you live in an are where there are many smaller cities close together (I.e., Las Vegas and North Las Vegas, or Seattle and Bellevue), you may miss important data if they’ve moved offices from one location to another.
Review Financial Data: Once you've located your prescriber, check out the financial data provided! See how your prescriber compares to the national average. If you’re viewing the chart (default), you’ll notice a blue line that represents your provider. You’ll also notice a yellow line that represents the US average across all providers, and a green line that represents the US average for all providers with this specialty. If you’re viewing your psychiatrist, for example, the green line will represent the average for all psychiatrists in the US. If you choose the "chart" viewing option instead, you'll get a detailed, year-by-year breakdown.
Understand the Data: Underneath the chart, you can click on “understand the data” for a more detailed breakdown of payment categories. This may also provide a clearer picture of the relationships your prescriber has with these entities.
While not all interactions between prescribers and pharmaceutical companies are inherently problematic, the potential for conflicts of interest exists. Accepting payments or gifts in exchange for prescribing specific medications can create a blurred line between medical decision-making and external influence. As patients, being aware of these dynamics empowers us to engage in informed conversations with our healthcare providers and make decisions that align with our best interests. Consider checking out OpenPaymentsData.cms.gov the next time you have an appointment with a new provider.