Open Payments Annual Report to Congress Shows Fourth Straight Year of $8 Billion Plus in Payments

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The Centers for Medicare & Medicaid Services recently published its Annual Report to Congress on the Open Payments Program. Since 2014, the first full year of reporting, annual payments from manufacturers to healthcare providers have exceeded $8 billion.

The Open Payments Program is a national disclosure program that “promotes a more transparent and accountable healthcare system” by providing information about financial relationships between manufacturers and health care providers. Payments are reported for the following three categories: general payments (payments not in connection with research, such as honoraria, consulting fees and travel compensation), research payments (payments in connection with formal research agreement), and physician ownership information (ownership or investment interests that physicians or immediate family members have in the manufacturers). The 2019 Annual Report discusses Program Year 2017 data, which was published by the Centers for Medicare & Medicaid Services (“CMS”) in June 2018.

In Program Year 2017, manufacturers reported $8.4 billion in payments, and ownership or investment interests, which represents a slight decrease from 2016. There are a total of 11.54 million payment records to 628,214 physicians and 1,158 teaching hospitals. From 2014, the first full year of data collection, through 2017, the total reported payments have been relatively steady, fluctuating between $8.02 billion and $8.81 billion per year. The 2017 payment breakdown by category is as follows: $2.82 billion in general payments, $4.66 billion in research payment, and $927 million in ownership or investment interests.

The report also notes that, during Program Year 2017, CMS implemented various enhancements to increase usability, both for the reporting aspects of the system and for the public facing website. Regarding the system enhancements, CMS implemented an expired physician license warning, increased characters limits for assumptions statements, and updated review and dispute screens for covered recipients. On the public facing website, CMS redesigned the homepage and the “Facts About Open Payments” page, and optimized the website to be fully mobile responsive for smartphone and tablet usage.

The Program Year 2017 certainly includes some surprisingly large numbers, such as the payment of $2.82 billion in general payments for honoraria, consulting fees and the like. We have previously reported that the Open Payments Database has increased transparency, but decreased patient trust of their doctors, even when the patient knew that their particular doctor had not received any industry payments. However, the payments from manufacturers to healthcare providers continue unabated for a fourth straight year. It seems likely that there will be increasing pressure from various stakeholders to limit collaboration with industry, and thus industry influence, on the healthcare system going forward.

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