The CMS next year will ask Medicare beneficiaries how their providers are doing under new payment models aimed at improving the quality of care while lowering cost.
But because the survey is voluntary and because the agency has allowed providers to ease into the new models, critics say the survey may not offer much insight.
The agency is asking to survey only the patients of providers participating in the Merit-based Incentive Payment System, the less risky of two options available under the Medicare Access and CHIP Reauthorization Act. Advanced alternative payment models such as accountable care organizations which share in savings or losses depending on whether they meet clinical quality targets and lower healthcare spending below a certain threshold.
Most providers are expected to participate in MIPS over APMs. The CMS anticipates beneficiaries from 461 practices will respond to the survey, which would equal approximately 187,990 providers. An average response of 287 beneficiaries per practice is expected, which adds up to approximately 132,307 beneficiaries potentially weighing about the first year of implementation.
Survey results will appear on the Physician Compare consumer website, something that confused critics of the survey.
“It's unclear how posting this information will help consumers make an informed choice on a doctor to pick with so few groups responding,” said Anders Gilberg, senior vice president of government affairs for the Medical Group Management Association, which represents 13,000 practices.
To draw participation, the CMS said it will provide bonus quality points to providers that volunteer their patients to be surveyed.
In January, providers participating in the Merit-based Incentive Payment System will begin reporting data on four performance measures; quality, resource use, use of electronic health records and clinical practice.
The survey will include questions currently being used to evaluate doctors under the Physician Quality Reporting System such as if patients were advised about ways to prevent illness or consulted with on specific health goals.
The survey request needs to be approved by the Office of Management and Budget. The CMS did not disclose how much it would spend on the survey.
The fact that the CMS is proposing to use the PQRS survey is also a source of concern for providers who say that survey is flawed.
“All that survey does is assess the patient's satisfaction, or experience of care,” said Dr. Gregory Fuller, a family medicine practitioner and chair of the Texas Medical Association's Council on Health Care Quality. “It doesn't have anything to do with quality of care.”
Still, "It's another opportunity for MIPS practices to get a read on their performance,” said David Introcaso, senior director for Regulatory and Public Policy at the American Medical Group Association. “It's hard to argue against them doing this.”