Be Well: Must Reads On Burritos and Medicare Part B

A Chipotle menu uses a range technique to lable food.
A Chipotle menu uses a range technique to lable food.

Burritos and the complications of food labeling

The 2010 Affordable Care Act includes a provision requiring restaurants and other establishments that serve food to put calorie counts on menus and in vending machines.

However some fast-food chains, like Chipotle, are providing menus that include a wide range of calories, as opposed to a specific number for consumers. The chain's food is prepared at a counter where where customers can ask a worker to add things like guacamole and sour cream as they walk down the line. Depending on what you choose the calories could be very high, or relatively low. So, the new menu is Chipotle's way of implementing the new law. It shows a wide range for a burrito from 350 to 970.

The online site Vox has a story about Chipotle's menu as a way to illustrate the complication of implementing this food labeling provision in the federal health law. The story can be found here.

Watching doctor payment

Medicare - the federal program for those over 65 years old - released what it pays individual doctors for Medicare Part B services.

Previously, the payments were known to federal officials but not public. The data was released as a result of a lawsuit by Dow Jones & Co., the parent company of the Wall Street Journal. The file includes billions of dollars worth of payments to doctors nationwide. When the information was released in April, national news organizations reported the release of information and some early findings. The Wall Street Journal's story package included details on some of the highest paid doctors in the country as well as perspective on how the data has many gaps.

The release of Medicare Part B data is noteworthy for a couple of reasons: First, the information was previously kept from the public. In addition, the information can be used to improve and change the way doctors are paid.

The Journal along with the New York Times and Washington Post provided links to searchable databases where readers could look up their own doctor and see how much he or she was paid in 2012.

However, the number that appears is not necessarily a full picture of a doctor's salary. In addition to Medicare Part B, doctors can be paid from private insurers as well as other government programs like Medicaid, which is coverage offered to those with certain income limitations. Also, doctors could also be getting payments from Medicare Advantage plans – or managed care plans that many seniors are enrolled in, and that wouldn’t show up in the database either.

And there’s one more significant caveat: One doctor could be the leader of a practice that has multiple practitioners billing Medicare, which means all of the Medicare payments to the whole practice could show up under that one doctor’s name.

New Yorker posted an analysis of the limits of the data with a story entitled "What Big Data Can't Tell Us About Health Care."

As news organizations and others begin to analyze the information, more stories will unfold.

Already, the investigative outfit ProPublica published a story cross-referencing the data with Medicaid fraud payments. ProPublica reporters found doctors who Medicare continued to pay even after Medicaid had suspended them for fraud. That story can be read here.

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