Applicable manufacturers and Group Purchasing Organizations (GPOs) collectively reported $10.90 billion publishable payments and ownership and investment interests to covered recipients in Program Year 2021. Program Year 2021 includes payments or transfers of value made between January 1, 2021 and December 31, 2021, and is the inaugural year for the Open Payments program expansion mandated by the SUPPORT Act.
Today, the Centers for Medicare & Medicaid Services (CMS) published Open Payments Program Year 2021 data, along with newly submitted and updated payment records for previous program years. The data is accessible at https://openpaymentsdata.cms.gov/
Open Payments is a national disclosure program that promotes transparency and accountability by making information about the financial relationships between applicable manufacturers and group purchasing organizations (GPOs) and physicians, physician assistants, advanced practice nurses, and teaching hospitals available to the public. Through this program, the public has access to a transparent and accountable healthcare system.
Program Year 2021 Highlights
Program Year 2021 is the inaugural year for the Open Payments program expansion, put into place under the SUPPORT Act of 2018. Beginning with Program Year 2021 the Open Payments definition of a “covered recipient” is expanded to include: physician assistants, nurse practitioners, clinical nurse specialists, certified registered nurse anesthetists, anesthesiologist assistants and certified nurse midwives.
For Program Year 2021, CMS published $10.90 billion in payments and ownership and investment interests made by applicable manufacturers and GPOs to physicians, physician assistants, advanced practice nurses and teaching hospitals. This amount is comprised of 12.10 million total records attributable to 533,056 physicians, 233,471 non-physician practitioners and 1,237 teaching hospitals.
Payments are reported across three categories: general payments, research payments, and ownership or investment interests. The dollar value in each of the three major reporting categories for Program Year 2021 are:
- $2.55 billion in general (i.e., non-research related) payments
- $7.09 billion in research payments
- $1.26 billion of ownership or investment interests held by physicians or their immediate family members
The Program Year 2021 data publication is the first Open Payments data publication that includes data about physician assistants and advanced practice nurses. Due to the program expansion and inclusion of these provider types as covered recipients the amount of data increased noticeably when compared to prior program years. However, the ratio of payment trends remains the same with the highest dollar value of the data being in research payments, and the largest number of records being in the general payment category.
Also, if the newly added covered recipients are removed from the Program Year 2021 data, the dollar value of the data as well as the number of records remains on par with previous program years, therefore we can attribute the noticeable increases in the data to the addition of the physician assistants and advanced practice nurses. Open Payments also considers the impact of the COVID-19 pandemic as reasoning to the decrease in amount of data for Program Year 2020. While there are lingering results from the global pandemic, the Program Year 2021 data may indicate a return to normal data trends for purposes of the Open Payments program.
The Open Payments data will be refreshed in early 2023 to reflect any updates made to the data since this publication.
For more information and resources, please visit: https://www.cms.gov/openPayments