For the first time, Medicare has published quality performance scores for individual physicians, but only for those who have volunteered data. About 6 in 10 doctors are included.
The results, published on the CMS Physician Compare website, scores doctors' performance on routine screenings and preventive care for common chronic conditions such as heart disease and diabetes.
Physicians whose names do not appear may have chosen not to submit data. But others have tried and failed, thanks to “inaccuracies and difficulties” with the CMS' data collection processes, said Dr. Steven Stack, president of the American Medical Association, in a written statement. The AMA criticized the agency for posting the incomplete data, arguing that patients might be concerned when scores are missing for their doctors.
“The AMA is a strong supporter of transparency, but today's action goes in the opposite direction—offering the public information that will lead consumers to draw faulty inferences about the quality of care that an individual physician or group provides,” Stack said. The AMA declined an interview request.
In addition to routine screenings, the newly published data describe how reliably physicians provide follow-up care for depression and high blood pressure, and how well they monitor patients for healthy weight and tobacco use. The data also include how often doctors double-check patient medications for possible problems, and whether they prescribe medications to help prevent heart attacks and stroke.
“We heard from consumers that they wanted both group information and individual physician information,” said Dr. Patrick Conway, CMS deputy administrator and chief medical officer.
The new information was released under the federal agency's push to publicly report quality results in ways useful to consumers. Under various provisions of the Affordable Care Act, the CMS has increased reporting requirements, and the use of financial incentives tied to performance on quality metrics.
In January, HHS announced an ambitious goal to increase the amount of spending tied to those incentives by 2018 under risk-based and value-based contracts. Yet the incentives under most contracts remain small, and critics question whether they will be effective.
“I think the improvement in delivery system reform, including quality, safety and moving to value-based payments in the last five years, has been more rapid than at any time in U.S. history,” Conway said. “I also think we need to continue to push to accelerate the pace of change and improvement.”
That push includes close attention to the design of those incentives, support for changes to care delivery and more information on healthcare costs and quality, he said.
The data on individual doctors must be reported by physicians, who face a penalty in 2016 if they opt out. The AMA has said that doctors have struggled to comply and received little help from the CMS.
Conway said the agency is working with the AMA and specialty medical societies on the reporting process. For doctors who have unsuccessfully tried to report data, “our goal is not to penalize them,” Conway said.
The CMS also released new and updated data for hospitals, medical groups and accountable care organizations, comprising preventive, patient-safety and chronic-disease scores for 275 medical groups, and patient experience measures for 290 medical groups.
The CMS added new measures for the quality of hospital surgical practices and infection rates for intensive care, and medical-surgical hospital units. Several other hospital measures were removed for which most hospitals had achieved high performance scores.
Correction Dec. 11, 2015:
About 6 in 10 doctors are included in the newly released quality data. An earlier version of the story reported 4 in 10 were included.