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Analysis

Fewer Physicians Accepting Industry Payments, But Payment Values Stay Steady

By Alexandra Wilson Pecci  
   November 03, 2020

A new study highlights the importance of tracking physician conflicts of interest.

Since the inception of a federal transparency program called Open Payments, fewer physicians have accepted payments from drug and medical device companies and group purchasing organizations, finds a study published today in JAMA.

Despite the decrease in the overall number of physicians accepting industry payments, the overall value of those payments has stayed the same, according to the study, led by Deborah Marshall, MD, MAS, of Icahn School of Medicine at Mount Sinai.

Open Payments is a federal reporting program started in 2013 that aims to bring transparency to industry-physician financial relationships and shine a light on potential conflicts of interest.

Under law, CMS collects and reports payment information to physicians and teaching hospitals and makes it searchable online for the public. The data is viewable by amount, company, and type of payment.

For instance, the tool shows that Mount Sinai Hospital in New York City received $945,775.67 in general payments in 2019, ranging from royalty and license payments to grants, gifts, and consulting fees.

The researchers for the new JAMA study evaluated trends in industry payments to physicians from 2014-2018, using a retrospective, population-based cohort of United States allopathic and osteopathic physicians practicing in 2014.

Of the 878,308 physicians in the study, 45% received at least one industry payment in 2018, which was down from 52.2% in 2014.

From 2014 to 2018, these physicians received 49.8 million payments totaling $9.3 billion. The total value was highest in medical and surgical specialties.

Although the proportion of physicians receiving payments decreased annually across all specialties, the total and annual payment values remained the same across every specialty except for primary care, for which total value decreased.

In 2014-2018, 90.1% of physicians received less than $10,000 in payments. Those who received more than $50,000 accounted for 3.4% of physicians receiving payments but those payments accounted for 82% of the total value.

"To our knowledge ours is the first study to demonstrate the consolidation of value in a relatively small number of physicians, which points to the limits of a national disclosure program in an era of increasing healthcare costs," the authors wrote.

Alexandra Wilson Pecci is an editor for HealthLeaders.


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