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December 11, 2015

For first time, CMS posts individual physician quality data, angering some

Daily Briefing

CMS on Thursday announced that for the first time it has posted quality performance data on individual physicians to its Physician Compare website.

The data include 2014 clinical quality performance measures for about 40,000 individual physicians who submitted information through Medicare's Physician Quality Reporting System. Doctors submitted the data voluntarily, although beginning in 2016 they will face a penalty if they opt out.

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According to Modern Healthcare, the data represent about 40% of physicians and include information on how often they:

  • Administer routine screenings and additional preventive care for common medical conditions, such as diabetes and heart disease;
  • Check patients' medications for potential issues;
  • Monitor patients for healthy weights and tobacco use;
  • Provide follow-up care for conditions such as depression and high-blood pressure; and
  • Provide medications to help prevent conditions like heart attacks and strokes.

CMS also posted certain 2014 clinical quality performance data for about 275 group practices, as well as patient experience measures for about 290 group practices.

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In addition, the agency updated quality data on accountable care organizations, group practices and hospitals.

For instance, CMS added new quality measures to its Hospital Compare website for hospital surgical practices and for certain health care-associated infections. CMS also removed several quality measures for which most hospitals had performed well. Further, the agency published patient experience and clinical quality data for about 20 Pioneer ACOs and more than 330 Medicare Shared Savings Program ACOs on its Physician Compare website.

AMA: Physician Compare data 'problematic'

American Medical Association (AMA) President Steven Stack in a statement said his organization was "dismayed" by CMS' decision to publish individual physician data.

"The AMA is a strong supporter of transparency, but today's action goes in the opposite direction—offering the public information that will lead consumers to draw faulty inferences about the quality of care that an individual physician or group provides," Stack said.

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He said there were "inaccuracies and difficulties" with CMS' data collection process, causing some physicians to be excluded from the Physician Compare site even when they tried to submit information.

Stack added that "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." He expressed concern that consumers may come to the wrong conclusions about physicians whose data are not included (Evans, Modern Healthcare, 12/10; Slabodkin, Health Data Management, 12/11; Walsh, Clinical Innovation & Technology, 12/10; Stack, AMA statement, 12/10).

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