What Big Data Can't Tell Us About Health Care

Jean Malouin, a family doctor in Michigan, woke up one morning earlier this month to an e-mail from a Washington Post reporter, who informed her that a vast release of Medicare payment data from 2012 had identified her as the highest female biller in the country, and the seventeenth-highest over all, with more than seven million dollars in payments. Malouin was soon inundated by interview requests from reporters, and her name appeared in newspapers across the country.

Malouin is a family doctor, which is not a specialty that one typically enters hoping to get rich. Delivering primary care is seen by doctors as hard work that earns comparatively little pay, and it is a job that is only getting harder. That’s because the Affordable Care Act, with the broad ambition of containing costs while improving quality, hopes to move away from a fee-for-service model, toward one in which doctors are paid primarily for keeping their patients healthy, a responsibility that will fall largely on primary-care doctors. At this point, nobody quite knows how to make this vision a reality, but Medicare has funded various demonstration projects to test innovations in care—one of which is led by Malouin, who supervises three hundred and eighty primary-care practices that treat a million patients in Michigan. Payments for care improvement from Medicare at all these clinics are made under Malouin’s name, which is how she ended up in dozens of newspaper reports on the data dump.

Full article here.

Originally posted in The New Yorker.