[Reblog] What’s Next For Physician Compare? | The Health Care Blog
From the 22 January 2015 post
Of the many hidden gems in the Affordable Care Act, one of my favorites is Physician Compare. This website could end up being a game changer—holding doctors accountable for their care and giving consumers a new way to compare and choose doctors. Or it could end up a dud.
The outcome depends on how brave and resolute the Centers for Medicare and Medicaid Services (CMS) is over the next few years. That’s because the physician lobby has been less than thrilled with Physician Compare, and, for that matter, with every other effort to publically report measures of physician performance and quality.
I’d give CMS a C+ to date. Not bad considering it’s the tough task. The agency has been cautious and deliberate. But after the many problems with Hospital Compare, Nursing Home Compare, Home Health Compare, and Dialysis Facility Compare—not to mention the shadow of healthcare.gov’s initial rollout—that’s understandable. They want, I hope, to get this one right from the get-go. And competition from the private sector looms.
Congress mandated that CMS establish Physician Compare by Jan. 1, 2011 and that an initial content plan be submitted by Jan. 1, 2013. CMS met those deadlines, albeit with a rudimentary site that launched in late December 2010. The agency updated its plans in 2013 and 2014, even as it added more content and functionality to the site.
The law requires the site to have “information on physician performance that provides comparable information on quality and patient experience measures.” That’s to include measures collected under the Medicare Physician Quality Reporting System (PQRS), Medicare’s main quality reporting vehicle, and assessments of:
- patient health outcomes and the functional status of patients
- continuity and coordination of care and care transitions, including episodes of care and risk-adjusted resource use
- the efficiency of care
- patient experience and patient, caregiver, and family engagement
- the safety, effectiveness, and timeliness of care
Notably, Congress set no deadline for the site to meet those specifications or be fully operational.
So what’s posted so far? The centerpiece of the site is a searchable directory of some 850,000 Medicare providers. That includes most of the practicing doctors in the U.S. with the exception of pediatricians and other physicians who don’t treat Medicare patients. This database predates the ACA and Physician Compare but its functionality, reliability and accuracy (a big complaint from physician groups) is being gradually enhanced.
Each doctor has his or her own profile page—a significant foundation that could accommodate quality and patient experience data in the future.
Consumers can also search three additional databases on the site. They identify doctors and other clinicians who participate in (a) PQRS; (b) the Electronic Prescribing Incentive Program; and (c) the electronic health record (EHR) incentive program (also called the meaningful-use program). About 350,000 physicians and other clinicians participate in the latter.
The bad news: these databases are separate and their content is not integrated. That makes searching for information on a particular group practice or individual doctor cumbersome and time consuming. And the databases aren’t user-friendly. On the plus side, for researchers and health administrators, the databases are downloadable.
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