Another
Healthcare Website Contractor Mess
by
Phil Mattera, Dirt Diggers Digest
The Obama Administration’s struggle with healthcare information technology is once again on display, with the release of the first wave of disclosure mandated by the Affordable Care Act on payments by drug and medical device corporations to doctors and hospitals.
These payments include consulting fees,
research grants, travel reimbursements and other gifts Big Pharma and Big
Devices lavish on healthcare professionals to promote the use of their wares —
in other words, what often amount to bribes and kickbacks. The new Open Payments system is said to document 4.4 million
payments valued at $3.5 billion for just the last five months of 2013.
This sleazy practice certainly deserves better transparency. Yet in announcing the data release, the Centers for Medicare & Medicaid Services (CMS) seemed to be sanitizing things a bit: “Financial ties among medical manufacturers’ payments and health care providers do not necessarily signal wrongdoing.”
Perhaps,
but very often that is exactly what they signal. Let’s not forget that many of
the big drugmakers have been prosecuted for making such payments as part of
their illegal marketing of products for unapproved (and thus potentially
dangerous) purposes. In 2009 Pfizer paid $2.3 billion and Eli Lilly paid $1.4 billion to settle such
charges.
Novartis consented to a $422 million settlement
in 2010. That same year, AstraZeneca had a $520 million settlement. Illegal
marketing inducements were among the charges covered in a $3 billion settlement GlaxoSmithKline consented to in 2012. The list goes
on.
While
the release of the aggregate numbers is useful, there are serious snafus in the
rollout of the search engine providing data on specific transactions. As
ProPublica is pointing
out, the new site is all but unusable for such purposes.
It is set up
mainly to allow sophisticated users to download the entire dataset, yet even
the wonks at ProPublica found that it did not function well in that way either.
Even
if one overcomes these obstacles, the ability to analyze financial
relationships between corporations and specific healthcare providers is limited
by the fact that some 40 percent of the records —
accounting for 64 percent of payments– are missing provider identities.
What
makes the disappointing Open Payments rollout all the more infuriating is that
it is being brought to us by the same infotech contractor, CGI Federal, that
was primarily responsible for the much bigger fiasco surrounding the
Healthcare.gov enrollment website a year ago.
The contractor is part of Canada’s
CGI Group, which as I noted in 2013, had a history of performance
scandals both in its home country and in the United States.
Problems
with the Open Payments site began even before its official public debut. Over
the summer, the portion of the site through which providers could register to
review the data attributed to them had to be taken
offline during a critical
period for nearly two weeks to resolve a “technical issue.”
As
with Healthcare.gov, it is likely that the government bashers will succeed in
putting most of the blame for the shortcomings of the Open Payments system on
the CMS.
Yet the real lesson of the websites, along with that of the U.S.
healthcare as a whole, is that the dependence on for-profit corporations
–whether they be pharmaceutical manufacturers, managed care providers or
information technology consultants — is always going to generate bloated costs
and plenty of inefficiency.