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Physician Compare – How will you “rank”?

Results of patient surveys that reflect patient experiences with such things timely care and medication instructions will soon be added to the Physician Compare website, which has been around since 2010. The website currently allows users to view information about Medicare physicians, such as name, primary and secondary specialties, practice locations, group affiliations, assignment status, education, residency and board certification information.

Medicare consumers also can learn which hospital(s) the physician is affiliated with and view the hospital’s profile via Hospital Compare to find out how a particular hospital is rated using Medicare star rankings from one to five, with five being the best.

Quality measures will continue to be used as tools to determine patient perceptions and clinical outcomes.

“Allowing Medicare patients to view physician ratings will help the consumer select a high quality provider,” policymakers at the Centers for Medicare and Medicaid Services (CMS) have said.  The more stars the better the provider, in theory at least.

The stars on Physician Compare do not rate or rank one group practice against another group or one health care professional against another heatlh care professional. This will change, and in 2017, CMS hopes to use benchmarks that will determine the “top performers,” creating a significant concern with Physician Compare. Unlike other consumer rating sites such as Yelp, Healthgrades and Angie’s List, the Physician Compare star ratings can impact reimbursement. Medicare payments may be adjusted negatively or positively for all Medicare patients for an entire one-year reporting period, depending on some of the outcomes reported on Physician Compare.

An education series on Medicare.gov encourages Medicare consumers to use the Physician Compare star ratings as a way to evaluate physicians on health care issues that are important to them by becoming involved in their care and, ultimately, in making more informed choices about personal health. See the graphic to learn what the physician profile will look like on Physician Compare and how the star ratings are displayed for consumer viewing.

For more information on MACRA and MIPS, visit www.kyma.org or contact KMA at Lady@kyma.org. You may also contact Medicare directly with Physician Compare questions at PhysicianCompare@Westat.com.

The stars are graphical representations of percentages. Each star represents 20 percentage points; i.e., 100 percent is five stars, 80 percent is four stars and so on. The display is for a group practice, although the information displayed is the same  for individual physcians.

In this example the group scored 73 percent on the “Getting a flu shot during the flu season” measure.

Reference: CMS Open Forum Teleconference on Physician Compare – 2016.

Physician Compare graphic

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