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Physician Compare website adds quality scores


By Andis Robeznieks
Posted: February 21, 2014 - 3:15 pm ET
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(Story updated with additional comment at 4:45 p.m. ET.)

The CMS is working to make its Physician Compare website more relevant to patients by adding quality measures related to the treatment of diabetes and heart disease for 66 group practices and 141 accountable care organizations.

The quality scores were developed from data generated from the groups that participated in the CMS Physician Quality Reporting System's Group Reporting Option and the ACOs participating in the Medicare Shared Savings Program, according to a CMS fact sheet. These groups and ACOs also were given 30 days to review their data for accuracy.

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The move comes as consumer awareness of physician-rating websites is growing.

Two big questions surround public disclosure of such data: Do these measures give an accurate reflection of the quality of care an organization delivers and is this information useful to patients in choosing where to receive care?

The consensus seems to be that quality measures reported on Physician Compare are a work in progress; their usefulness and accuracy should continue to improve over time.

“This is a first-year attempt to quantify quality performance,” said Dr. Jerry Penso, chief medical and quality officer with the American Medical Group Association. “Let's take it as a learning year, and not put too much emphasis in the numbers.”

Transparency and accountability are two core values of the AMGA, Penso said, and so by posting this data, the CMS is moving in the right direction. The measures listed are also good patient education and engagement tools, he added.

Shari Erickson, vice president of governmental and regulatory affairs with the American College of Physicians, said the measures are well validated with a strong evidence base behind them, though it remains to be seen how useful patients will find them.

The data display on the Physician Compare website has improved, Erickson added, but she would like some context given so patients better understand why these measures are important.

The minimal patient sample size per measure was 25 and the groups—not individual doctors in the group—are rated on a one-to-five star scale. Erickson said that the CMS should post how many patients were included in each measure. She explained that it's useful to know whether a four- or five-star rating was generated from data from 30 patients or 300.

According to the CMS Physician Compare Reporting Plan (PDF), individual performance measures could be posted late this year “if technically feasible.” The plan also calls for expanding to groups with 100 or more physicians who report measures via the Group Practice Reporting Option or through specialty societies registries in 2015, again, “if technically feasible.”

Dr. Reid Blackwelder, president of the American Academy of Family Physicians, declared the “CMS got this right” and praised the agency for providing much-needed transparency. But then he added that Physician Compare quality reporting was only at its starting point and explained that the accuracy of its data needed improvement—as did the overall website.

“The site's usability in general is less than friendly, but CMS' spirit of quality measurement and transparency is sound,” Blackwelder said. “The current implementation and the resulting data available through Physician Compare are flawed, but repairable."

Physician Compare, while still a work in progress, still can help patients determine whether a practice is keeping up with developments in health information technology and staying on top of evidence-based treatment protocols, Blackwelder said.

Physician Compare was created as part of the Patient Protection and Affordable Care Act and launched at the end of 2010.

The CMS promised that the website will continue to improve.

“This is an important first step in publicly reporting quality measures on Physician Compare," Dr. Patrick Conway, CMS CMO and deputy administrator for innovation and quality, said in a release. "Offering a strong set of meaningful quality measures on the site will ultimately help consumers make decisions and it will encourage quality improvement among the clinician community, who shares CMS' strong commitment to the best possible patient care.”

Penso said that, ultimately, a performance rating system needs to capture three things: the patient experience, quality (assessed with validated measures), and meaningful-cost reporting so people can gauge the value of the care they are receiving.

AMGA member groups are working with the National Quality Forum and the CMS to make sure performance measures are accurate, that reporting rules and criteria are well understood, and that the reporting process is as least burdensome as possible.

Quality-improvement reporting still remains a big administrative burden for most healthcare organizations, Penso said, because government programs and private insurers all generally ask for the same information but in slightly different ways. “The issue our members have is there isn't a core set of measures that applies to their total patient population.”

Follow Andis Robeznieks on Twitter: @MHARobeznieks


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