What do patients think about the Open Payments program?

A new study may give doctors of optometry a hint of the public's perception regarding Open Payments reporting, a federal program designed to make transparent relationships between health professionals and teaching hospitals and industry.

Under the program (also known as the Sunshine Act), authorized under the Affordable Care Act, manufacturers and group purchasing organizations must report annually certain payments and other transactions of value given to physicians and teaching hospitals. The disclosures, which are reviewed by physicians before they are published online, are meant to promote transparency and accountability, according to the Centers for Medicare & Medicaid Services (CMS).

Published in JAMA Ophthalmology on Dec. 18, the results of the study were based on questionnaires given to 407 patients at three ophthalmology clinics affiliated with Columbia University Medical Center in New York, New York. Researchers were affiliated with Columbia University, New York, the University of British Columbia, Vancouver, British Columbia, and the University of Wisconsin, Madison, Wisconsin

The results:

• 7.7% were aware of the Open Payments program.
• 29.4% were planning to access the public database operated by the CMS, though few (3.1%) had attempted to go to the website.
• 53.5% indicated they wanted to know if their doctors receive payments from industry.

The researchers, noting that more research was needed on the subject, also reported that patients had concerns about the industry payments (41.9% disapproved).

Transparency

Publicly reported payments received by doctors include:

• Cash or cash equivalent.
• In-kind items or services.
• Stocks, stock options, or any other ownership interest, dividend, profit or other return on investment.
• Any other form of payment or other transfer of value.

Payments can be for travel and lodging, grants, research, consulting fees, gifts, honorarium, education, and food and beverages. Read more about the nature of payments that must be reported.

CMS does not prohibit these payments; in fact, it calls them mutually beneficial because they "contribute to the design and delivery of life-saving drugs, devices, biologicals, and medical supplies."

Plus, provided the relationships don't create a conflict of interests for doctors, transparency can help build trust between patients and doctors, members of the AOA Ethics and Values Committee (EVC) have pointed out.

"As optometrists, we have a moral obligation to abide by our Standards of Professional Conduct (section on relationships with industry)," says EVC member Kenneth Lawenda, O.D. "The Open Payments program provides an additional level of confidence in the doctor-patient relationship by providing another layer of openness and transparency that patient care is not influenced by conflicts of interests."  

Adds Doug Totten, O.D., chair of the EVC committee: "The availability of accurate and understandable data can be a helpful resource for the public as it can help promote accountability between providers and industry and aid the evaluation of individual providers. However, it is critical that the information presented in the Open Payments system be correct, so each optometrist should verify the information being presented to the public. Inaccurate or poorly defined information may actually harm a doctor-patient relationship when no wrongdoing was intended or had occurred."  

Under the law, the annual database is published on June 30 and is preceded by a 45-day period of review and dispute process by physicians.