CMS announced that it has updated its Physician Compare website to include 2016 data and new star ratings related to clinical quality. The first quality measures were added to Physician Compare in February 2014. Since then, CMS has continued a phased approach to public reporting.
2016 Performance Information on Physician Compare
Beginning in December of 2017, CMS started to publicly report certain 2016 performance information on Physician Compare. The information was designated as available for public reporting in the 2016 Physician Fee Schedule final rule. According to CMS, the primary audience for profile pages is patients and caregivers. On the profile pages, groups may have the following measures reported: a subset of 2016 Physician Quality Reporting System (PQRS) measures reported as star ratings; Consumer Assessment of Healthcare Providers and Systems (CAHPS) for PQRS summary survey measures; and/or non-PQRS Qualified Clinical Data Registry (QCDR) measures.
The measures now included on Physician Compare profile pages represent a variety of types of clinical care by groups representing many different specialties. The 2016 PQRS performance information is divided into eight different categories, ranging from general care to more specialized care.
The categories include:
- Preventive care: General health
- Preventive care: Cancer screening
- Patient safety
- Care planning
- Diabetes
- Heart disease
- Respiratory diseases
- Behavioral health
In addition to the measures being reported for groups and individual clinicians, 2016 data for the Shared Savings Program, Pioneer, and Next Generation Accountable Care Organizations (ACOs) are now also publicly reported on Physician Compare.
Star Ratings on Physician Compare
When public reporting performance information began in 2014, CMS started with a small subset of group-level Web Interface measures. Now with the use of star ratings, CMS is restarting its phased approach for the use of star ratings with just a small subset of group-level measures. For the first time this year as part of the continued phased approach to public reporting, CMS has publicly reported a small subset of 2016 PQRS group-level measures on group profile pages as star ratings.
How the Star Rating is Constructed
After extensive research and outreach, and hearing what stakeholders wanted to see in a benchmark and understanding the concerns and cautions raised, CMS proposed an item-level (or measure-level) benchmark using the Achievable Benchmark of Care (ABC) methodology. This benchmark was finalized in the CY 2016 Physician Fee Schedule final rule. The ABC benchmark is the “5-star rate,” serving as the anchor for the star rating methodology.
More Information
Clinicians can visit the CMS Physician Compare Initiative page for information on keeping their general information current and troubleshooting problems, and to learn more about public reporting. For questions about public reporting and keeping information current, the Physician Compare support team can be reached at PhysicianCompare@Westat.com.