Physician Compare: What Is CMS Posting about Me?
You’ve probably heard about CMS’ Physician Compare Website. You may even know that the development of this public website is a statutory mandate from the Affordable Care Act. Unfortunately, what many physicians and members are not aware of is the information that’s available about them, and their practices, on this website. The first thing members should know is that this program is updated and modified on an annual basis through federal rulemaking. This means that CMS will announce proposed revisions or additions to the Physician Compare Website in the notice of proposed rulemaking (NPRM) of the Medicare Physician Fee Schedule (MPFS) each calendar year. They then accept feedback on their proposals from the public during a 60-day comment period and finalize their policies in the final MPFS for that year, typically published on or around November 1 each year. The Website can be accessed at: http://www.medicare.gov/find-a-doctor/(X(1)S(0grwmc55y5poo245uxj5ifv5))/provider-search.aspx?AspxAutoDetectCookieSupport=1. Background The Physician Compare Website was launched in December 2010 and originally included data on those eligible professionals (EPs) who successfully reported on the Physician Quality Reporting System (PQRS) measures in CY 2009. Today, the Website includes the following information on providers: The provider’s primary, and any applicable secondary, specialty(ies); The provider’s practice locations; The providers group practice or hospital affiliations, where applicable; The provider’s education information, language skills, and gender; The names EPs who have successfully reported on quality programs, specifically e-prescribing and PQRS for CY 2011. What to Expect in 2013 By January 2013, CMS is required to outline a plan for posting information on provider’s quality performance, as well as patient experience data, on the Physician Compare Website. CMS is presently undertaking a full Website redesign project aimed at improving the usage and function of the site. In addition, CMS has finalized the following information for release in CY 2013: 2012 data on PQRS Group Practice Reporting Option (GPRO) measures for practices that meet the minimum sample size of 20 patients; Whether providers accept Medicare patients; Board certification information; and Improved information on language skills and hospital affiliations. As part of the Website redesign project, CMS allowed the Academy to view and comment on the proposed redesign. In the letter, the Academy addressed several issues included in the proposed redesign. Visit the Academy’s “What’s New” page at: http://www.entnet.org/Practice/CMS-News.cfm to access the full letter. Areas addressed by the Academy included: Data accuracy is paramount in the physician compare site and CMS proposes including claims based verification for physician information rather than just relying on PECOS; Concern regarding the small sample size used for posting information such as participation in PQRS GPRO; The posting of GPRO performance rates and the need for a review period to ensure the data posted is accurate; and The inclusion of CG-CAHPS survey data, as well as the S-CAHPS data, into the Physician Compare website. What to Expect in 2014 and Beyond For 2014, CMS anticipates posting information on provider performance rates on measures reported by physician groups or Accountable Care Organizations (ACOs) via the GRPO web interface system. These groups will have 30 days to review their information for accuracy before it becomes publicly available. CMS also hopes to post patient experience survey data gathers using the CG-CAHPS survey method for groups of 100 or more providers. Finally, CMS will post information on providers who obtain PQRS maintenance of certification incentives during CY 2014. Other information CMS is considering for inclusion on the website in the future are performance on quality measures developed by specialty societies, continued efforts to align the PQRS and value based payment modifier (VBP) program measures, the release of provider performance in these programs, as well as individual EP performance measure data. Data Accuracy Currently, the website pulls physician information from the PECOS enrollment system. CMS plans to verify the accuracy of PECOS information via a claims based verification, which the Academy supports. Until these changes are implemented, the Academy encourages members to check their PECOS enrollment information, as well as what information is currently available about them on the Physician Compare website, and to contact CMS if they find the information is incorrect. The Academy’s health policy team will continue tracking the development of this important public website and will alert members to any key changes to the program in the future. Should you have any questions or concerns about the website, or your publicly available information, please contact us at healthpolicy@entnet.org.
You’ve probably heard about CMS’ Physician Compare Website. You may even know that the development of this public website is a statutory mandate from the Affordable Care Act. Unfortunately, what many physicians and members are not aware of is the information that’s available about them, and their practices, on this website.
The first thing members should know is that this program is updated and modified on an annual basis through federal rulemaking. This means that CMS will announce proposed revisions or additions to the Physician Compare Website in the notice of proposed rulemaking (NPRM) of the Medicare Physician Fee Schedule (MPFS) each calendar year. They then accept feedback on their proposals from the public during a 60-day comment period and finalize their policies in the final MPFS for that year, typically published on or around November 1 each year. The Website can be accessed at: http://www.medicare.gov/find-a-doctor/(X(1)S(0grwmc55y5poo245uxj5ifv5))/provider-search.aspx?AspxAutoDetectCookieSupport=1.
Background
The Physician Compare Website was launched in December 2010 and originally included data on those eligible professionals (EPs) who successfully reported on the Physician Quality Reporting System (PQRS) measures in CY 2009.
- Today, the Website includes the following information on providers:
- The provider’s primary, and any applicable secondary, specialty(ies);
- The provider’s practice locations;
- The providers group practice or hospital affiliations, where applicable;
- The provider’s education information, language skills, and gender;
- The names EPs who have successfully reported on quality programs, specifically e-prescribing and PQRS for CY 2011.
What to Expect in 2013
By January 2013, CMS is required to outline a plan for posting information on provider’s quality performance, as well as patient experience data, on the Physician Compare Website. CMS is presently undertaking a full Website redesign project aimed at improving the usage and function of the site. In addition, CMS has finalized the following information for release in CY 2013:
- 2012 data on PQRS Group Practice Reporting Option (GPRO) measures for practices that meet the minimum sample size of 20 patients;
- Whether providers accept Medicare patients;
- Board certification information; and
- Improved information on language skills and hospital affiliations.
As part of the Website redesign project, CMS allowed the Academy to view and comment on the proposed redesign. In the letter, the Academy addressed several issues included in the proposed redesign. Visit the Academy’s “What’s New” page at: http://www.entnet.org/Practice/CMS-News.cfm to access the full letter. Areas addressed by the Academy included:
- Data accuracy is paramount in the physician compare site and CMS proposes including claims based verification for physician information rather than just relying on PECOS;
- Concern regarding the small sample size used for posting information such as participation in PQRS GPRO;
- The posting of GPRO performance rates and the need for a review period to ensure the data posted is accurate; and
- The inclusion of CG-CAHPS survey data, as well as the S-CAHPS data, into the Physician Compare website.
What to Expect in 2014 and Beyond
For 2014, CMS anticipates posting information on provider performance rates on measures reported by physician groups or Accountable Care Organizations (ACOs) via the GRPO web interface system. These groups will have 30 days to review their information for accuracy before it becomes publicly available. CMS also hopes to post patient experience survey data gathers using the CG-CAHPS survey method for groups of 100 or more providers. Finally, CMS will post information on providers who obtain PQRS maintenance of certification incentives during CY 2014.
Other information CMS is considering for inclusion on the website in the future are performance on quality measures developed by specialty societies, continued efforts to align the PQRS and value based payment modifier (VBP) program measures, the release of provider performance in these programs, as well as individual EP performance measure data.
Data Accuracy
Currently, the website pulls physician information from the PECOS enrollment system. CMS plans to verify the accuracy of PECOS information via a claims based verification, which the Academy supports. Until these changes are implemented, the Academy encourages members to check their PECOS enrollment information, as well as what information is currently available about them on the Physician Compare website, and to contact CMS if they find the information is incorrect.
The Academy’s health policy team will continue tracking the development of this important public website and will alert members to any key changes to the program in the future. Should you have any questions or concerns about the website, or your publicly available information, please contact us at healthpolicy@entnet.org.