Health and Medical News and Resources

General interest items edited by Janice Flahiff

[Reblog] What’s Next For Physician Compare? | The Health Care Blog

What’s Next For Physician Compare? | The Health Care Blog.

From the 22 January 2015 post

Screen Shot 2015-01-23 at 9.33.17 PMOf 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.

January 26, 2015 Posted by | health care | , , , , , , | Leave a comment

Health Law Helper – Affordable Care Act Interactive Tool

Health Law Helper – Affordable Care Act Interactive Tool.

From the Consumer Reports Web site

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Related Affordable Care Act (Obamacare) Resources 

Information about the Act (Obamacare)

Other pages at HHS.gov/healthcare (US Dept of Health and Human Services)

  • Live Chat courtesy of  the US Department of Health and Human Services (HHS)
  • Prevention and Wellness with information on how many insurers are required to cover certain preventive services at no cost to you.

October 1, 2013 Posted by | health care | , , , , | 1 Comment

Department of Health and Human Services Updates HealthCare.gov Insurance Finder

HealthCare.gov

Take health care into your own hands

 

From the press release

HealthCare.gov Insurance Finder Gets Better for Consumers

On Monday, November 15, 2010, the Department of Health and Human Services updated the HealthCare.gov Insurance Finder with more information on private insurance plans.

Created under the Affordable Care Act, www.HealthCare.gov was launched July 1, 2010, and is the first website of its kind to bring information about private and public health coverage options into one place to make it easy for consumers to learn about and compare their insurance choices.

HealthCare.gov and its Insurance Finder are critical new tools for consumers, making the health insurance market more transparent than it has ever been.

On October 1, the Insurance Finder added price estimates for private insurance policies for individuals and families, allowing consumers to easily compare health insurance plans – putting consumers, not their insurance companies, in charge and taking much of the guesswork and confusion out of buying insurance.

Insurance companies are also required to include two notable metrics never before made public:

  • The percentage of people who applied for insurance and were denied coverage.
  • The percentage of applicants who were charged higher premiums because of their health status.

Significant Increase in Options for Consumers to Compare & in Number of Health Insurance Companies in Finder

Today’s update represents a significant increase in the number of private insurance plans and the number of issuers represented:

  • On October 1, there were 4,400 plans for individuals and families listed in the Finder, and today’s update brings that number to over 8,500.
  • On October 1, there were 230 health insurance companies the individual and family market represented in the HealthCare.gov Insurance Finder, and today’s update brings the number of health insurance companies in the Finder to 299.

This update to HealthCare.gov further enhances the ability of Americans to find health care coverage that meets their needs and get the best value for their money.  And it represents a significant expansion in the transparency that HealthCare.gov is bringing to the insurance marketplace – transparency that leads to more competition between insurers and better value for consumers.

Posted: November 15, 2010

November 28, 2011 Posted by | Consumer Health, Public Health | , , , | Leave a comment

   

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