A Salem rheumatologist received more money from Medicare in 2012, $2.7 million, than any other doctor in Oregon.
Dr. Rebecca Callis practices at Salem Rheumatology, having treated 547 Medicare patients. The next highest earning rheumatologist in Oregon was Dr. Gregory Borstad in Bend, with $1.2 million. The data show that he had 684 beneficiaries.
The national data was released by the U.S. Centers for Medicare and Medicaid Services last week, revealing for the first time how much individual physicians received from the federal health insurance program for people 65 years and older.
The new data set has information for more than 880,000 health care providers who collectively received $77 billion in Medicare Part B payments in 2012. The data include physicians’ professional services, but not fees charged by hospitals associated with those services.
Callis declined to be interviewed, but wrote in an email that the data does not indicate a doctor’s profits. The money also goes toward overhead, employee wages and medications practices must pay for up front to treat their patients.
“I am fortunate to treat a number of patients in the Salem area, many of whom benefit from IV infusions used to treat and control an often otherwise debilitating autoimmune disease,” Callis wrote. “A significant portion of Medicare reimbursement is related to the purchase and administration of these necessary, albeit expensive, therapies.”
However, she did not provide specifics on how her practice is different from other rheumatology practices in the state. The data show she billed for 114,575 services, while her colleagues’ numbers range from 3,000 to 29,000 services.
Callis said she simply didn’t know why her numbers were so much higher than that of other rheumatologists — the other physicians at her practice bill under their own names.
In Salem, ophthalmology was a well-represented specialty in the Medicare data. Three doctors who specialize in retina care were among the highest paid, all from Retina Consultants LLC. Their payments ranged from $499,087 to $766,757.
One of the practice partners, Dr. Andrew Westfall, said there are certain conditions in his specialty — macular degeneration, diabetic retinopathy, retinal vein occlusion — that require injections of drugs that cost about $2,000.
Because they have to be administered at the practice, the doctors pay for the drugs up front then bill Medicare for reimbursements. Those could hike up their payment figures, even though they may just be breaking even on the drugs.
“That’s why ophthalmology looks out of whack,” Westfall said.
In addition, eye diseases generally affect older patients, meaning they have a higher share of Medicare beneficiaries, he said.
Dr. Scott Stice, a general ophthalmologist with Eye Care Physicians & Surgeons, added that ophthalmology has high overhead because it’s a specialty that involves a lot of expensive equipment. The most common procedure at his practice is cataract surgery, he said.
Doctors nationwide have expressed concerns the data would be misinterpreted and taken out of context.
Stice, president of the Marion-Polk County Medical Society, said he knew the data were coming and he saw its release as another testament of the pressures the medical industry is under to be more efficient.
“The thing that’s frustrating is you see your name out there, but it could be misinterpreted,” he said. “It helps drive the concept that doctors make loads more than everyone else.”
Dr. James Gajewski, who is on the board of trustees of Oregon Medical Association and co-chairman of the health care finance committee, said improving transparency in health care spending is a positive thing — even if there are flaws in the numbers. He hopes as billing practices change, the numbers could also be more reflective of reality.
Gajewski is also a professor of medicine at Oregon Health & Science University.
“It increases public scrutiny, but on the other hand, when you accept public funds scrutiny goes with it,” he said.
syoo@StatesmanJournal.com, (503) 399-6673 or follow at Twitter.com/syoo.
Medicare provider payments 2012
Highest paid providers in Salem
Dr. Rebecca Callis
Dr. Samuel Farmer
Dr. William Pierce
Dr. Edmund Servais
Dr. Poly Chen
Dr. Andrew Westfall
Dr. Michael Goodenberger
Dr. Andrew Linn
Dr. John Girod
Dr. Diane Cockburn