What is Medicare Physician Compare?

Medicare Physician Compare is a website hosted by the Centers of Medicare & Medicaid Services (CMS) that lists physicians that accept Medicare patients. Currently the website hosts basic physician information, but CMS intends to expand this to include performance scores physicians will earn under measures outlined by the Medicare Access & CHIP Reauthorization Act of 2015 (MACRA).

What information will the Medicare Physician Compare include?

CMS outlined in proposed Quality Payment Program (QPP) rules that the Medicare Physician Compare will be extended to include more providers, their practice information, and the ability for patients to compare providers. CMS has also proposed the addition of public reporting of the following clinician data under the Merit-based Incentive Payment System (MIPS):

  • Clinician Current Population Survey’s (CPS)
  • Clinician performance under each MIPS performance category
  • Names of clinicians eligible for APMs, the names of such APMs, and the performance of these models
  • Periodically post aggregate information on MIPS, including the range of composite scores for all MIPS eligible clinicians and the range of the performance of all MIPS eligible clinicians with respect to each performance category

Efforts Towards Secure, Accurate Data

Because of the lasting impact this will have on clinicians, CMS’ proposed ruling requires processes that ensure all data available on Medicare Physician Compare is statistically valid, reliable, and accurate, including risk adjustment mechanisms used by the Secretary. The rule also states that information available should be easy to understand by the public, and must be comparable.

Section 1848(q)(9)(C) of MACRA dictates that a process must be made available to clinicians eligible under MIPS to submit corrections regarding inaccuracies regarding their practices data. The rule proposes a 30 day preview period in advance of the publication of any data on Physician Compare.

CMS will also coordinate efforts between Physician Compare and the four performance categories of MIPS for accuracy of data review and appeal any relevant data resubmission or correction. All data to be made available for public reporting, such as measure rates, scores, and attestations, will be available for review and correction during the review process. In accordance with Section 1848(q)(9)(C) of MACRA the process will begin at least 30 days in advance of the publication of new data. Data under appeal and review will not be publicly reported until the review is complete. All corrected measure rates, scores, and attestations submitted will be available for public reporting.

Greater Transparency

A positive step towards patient centric healthcare, the Medicare Physician Compare means greater transparency between physicians and their patients. It is also a means for CMS to encourage greater performance from physicians. Due to the popularity, and widespread use of online physician reviews, the portal was initially meant for patients to survey physicians in their area. Now the platform will be expanded to include CMS performance scores, and also be used as a means for physicians to check their ranking and improve on it.