pumping action of the heart in pa- tients who have both heart disease and certain other conditions.
Physician Compare lists each measure separately, along with information to help patients understand it. The site dis- plays scores for how well the group per- formed on each measure as a percentage and a corresponding five-star scale. For example, each star represents 20-percent compliance, so if a group scored 84 per- cent on a measure, patients would see four stars and part of a fifth. For now, the data apply only to ACOs
and group practices of 100 or more phy- sicians. CMS initially anticipated includ- ing quality data for all individual physi- cians by 2017 but has not yet specified any dates.
The new quality scores released come
from the 2012 quality data that physi- cian groups and ACOs reported to CMS through the PQRS, eRx, and EHR pro- grams. TMA officials add that if CMS sticks to its 2017 target for publicizing individual physician quality scores, for example, that information would be based on 2015 reporting. That means physicians aren’t helpless when it comes to the information Phy- sician Compare presents to patients, Dr. Walters says. He acknowledges the qual- ity reporting process can be costly and time-consuming, especially for smaller practices. Still, “if you are concerned about the quality of the information being out there in the public forum in future versions of Physician Compare, you are completely in control of that quality be- cause you provide the data,” he said. Dr. Walters adds physicians’ specialty societies, not CMS, largely develop the quality measures physicians report and patients ultimately see. (See “Measure of Success,” April 2013 Texas Medicine, pages 59–63, or visit
www.texmed.org/ MeasureOfSuccess.)
On the other hand, he says Medicare’s
track record with Physician Compare is less than perfect. Dr. Walters was among a number of physicians who found in- accuracies in his demographic profile in the first version of Physician Compare. He works at MD Anderson Cancer Cen-
June 2014 TEXAS MEDICINE 31
ter, but the website listed him with an- other hospital in town. TMA’s Payment Advocacy Department has fielded similar complaints about mismatched data. Officials say such mis- takes occur mostly because Medicare does not regularly update the Provider Enrollment, Chain and Ownership Sys- tem (PECOS) it uses to update Physician Compare. The department recommends physicians carefully and regularly moni- tor their profiles to catch any errors. The faults are just one reason orga- nized medicine has urged CMS to hold off on expanding Physician Compare with performance data. “Furthermore, it undermines physicians’ trust in CMS’ ability to expand and correctly post their
quality scores on Physician Compare,” AMA Executive Vice President and Chief Executive Officer James L. Madera, MD, told federal officials in a March letter. CMS gave group practices 30 days to
preview their quality measures before publicly reporting them, and the agency says it will correct any errors. But there is no formal appeal process. Already, physicians often wait months to see the changes they make in PECOS show up on Physician Compare, the AMA letter states. In addition, “the AMA, medical specialty societies, and state medical societies received no advance notice regarding the posting of this [quality] information. Consequently, we were unable to notify the physician com-
Going public
Here’s a snapshot of the quality data patients now see when they look up certain physician groups on Medicare’s Physician Compare website.
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