Practice Economics

Physician Compare: Expanded data cause concern


 

References

Potentially inaccurate data posted on the federal Physician Compare website could misinform patients and lead to incorrect assumptions about the quality of care individual doctors provide.

With the most recent update of Physician Compare, the Centers for Medicare & Medicaid Services for the first time has posted individual physician performance scores on the 40,000 individual health care professionals who are part of the Physician Quality Reporting System (PQRS).

Dr. Steven J. Stack

Dr. Steven J. Stack

“Given the widespread accuracy issues with the 2014 PQRS calculations, the newly released information is premature,” American Medical Association President Steven J. Stack said in a statement. “The data inaccuracies and difficulties with CMS’s processes grew over the last couple of months and, while CMS has acknowledged these problems, it has failed to address the underlying issues. Most importantly, consumers visiting the Physician Compare website are likely to get a false impression that it provides accurate quality information for all physicians, when in fact, due to significant data problems, the newly added information covers only about 40,000 physicians.”

Although the concept of Physician Compare makes sense, the CMS needs to resolve data inconsistencies and improve how the information is being presented before posting new information to the site, said Dr. Wanda Filer, president of the American Academy of Family Physicians (AAFP). Performance scores on each measure are displayed on Physician Compare as stars followed by a percent, with each star representing 20%.

“A star rating system is too simplistic to provide for informed decisions [and] doesn’t reflect the complexity or context of care that undergirds those measures,” Dr. Filer said in an interview. “Given that complexity, it is likely that inaccurate data will be attributed to a physician’s care.”

In an effort to reduce inaccuracies, the AAFP had called for an extended period – from the current 30 days to 90 – for physicians to review their data before the data are published, Dr. Filer said.

She added that the CMS takes too long to communicate with physicians about their performance scores. Doctors do not receive reports for 6-9 months, reducing the opportunity for them to improve their performance before the next reporting period, she said.

“CMS needs to provide feedback to physicians much sooner so improvement can take place before their data are posted on the next Physician Compare,” Dr. Filer said. “Moreover, CMS must do a better job educating physicians about this website and their opportunity to review and correct any accuracies in what is reported.”

Karl A. Thallner Jr.

Karl A. Thallner Jr.

In addition to posting new PQRS measures on Physician Compare, the CMS also has posted 2014 data from group practices that report patient experience measures through the Consumer Assessment of Healthcare Providers and Systems (CAHPS) for PQRS survey. The CAHPS survey measures Medicare patients’ feedback about their care experiences. Updated performance scores for accountable care organizations, including clinical quality of care and patient experience measures for Shared Savings Program ACOs and 20 Pioneer ACOs were also added.

The reporting of the new data may be welcome for some physicians or group practices that are achieving high scores under quality-reporting programs, noted Philadelphia health law attorney Karl A. Thallner Jr.

“However, a physician who does not participate or who does not have high scores may feel that the reported data does not provide an accurate picture of the quality of care that he/she provides to patients, and therefore may be misleading to consumers,” Mr. Thallner said in an interview. “Also, physicians may not report data consistently, making differences between physicians less relevant.”

agallegos@frontlinemedcom.com

On Twitter@legal_med

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