The Physician Compare website: A work in progress
Physician Compare is a publicly available website – mandated by the Affordable Care Act (ACA) - on which Medicare posts information about physician performance and quality of care. Consumers have a significant interest in the information posted on Physician Compare because it helps them to evaluate and choose physicians. As we all know, carriers, employers, insurance and governmental agencies are paying more and more attention to the data posted on the Physician Compare website as the source of quality information. They have based their contracts and payment incentives on this information.
The Physician Compare website is modeled after the Hospital Compare website. Hospital Compare is recognized as having motivated hospitals to improve quality of care as well as having had a major role in improving patient safety. It is given a great deal of credit for saving at least 50,000 lives in the period of time from 2010 to 2013.
In the same way, the Physician Compare website is expected to be a major factor in improving quality and safety of physician care by CMS, carriers and the public. According to the Robert Wood Johnson Foundation Directory of 208 provider report card incentives, there are about 50 efforts underway to assess and report on physician performance. Some of this data will end up as part of the data your patients will see when they check you out on the Physician Compare website.
There is concern that many of the ratings are based on low numbers of reviews and may not be statistically valid. While Physician Compare recently came online, there are an increasing number of commercial online ratings of physicians, and data evaluating physician quality of care and performance. It is also fairly clear that an increasing number of people are going to the commercial websites for assistance in choosing both primary care physicians and specialists. Data, which is included on the Physician Compare website, will reflect PQRS reporting, will include data coming from members of the public rating physicians online (more than 1 million people visit the Healthgrades website each day and many of them post reviews of hospitals and doctors), and will include reports of physicians who participate in ePrescribing, etc.
There are problems with the data; much of it is being based on process measures rather than outcome measures. In addition, there are issues with risk adjustment of the data. The AMA, in a letter to CMS in August 2014, stated they would “adamantly oppose the multiple proposals to extensively expand the Physician Compare website as serious and fundamental flaws in errors remain unaddressed.”
Is there anything you can do about this? Unfortunately, not much. Physician Compare, the major website in this area, is a work in progress. If you feel you are misrepresented by the data, Updating and Editing Data on Physician Compare explains how to correct data in your profile and provides answers to frequently asked questions. Alternatively, supply the Advocacy Council with a succinct report as to why you think your data is incorrectly rated. When we get enough comments to make a difference, we will take them forward and see if we can impact on what is being reported - at least in our specialty. If you are silent no one will ever know your data is wrong. The Advocacy Council will try to be your voice to bring about a more reasoned public reporting activity.