4 Highlights of Physician Compare You Need to Know for 2016

Physician speaking with couple in his office

At the end of February, CMS hosted a webinar to unveil the new features of Physician Compare and describe the impact of these changes. Over the course of an hour-long presentation, four main takeaways emerged.

Four Things You Need to Know

  1. Physician Compare now includes Star Ratings.
  2. CMS is publishing CAHPS scores for groups and ACOs that participated in 2014.
  3. CMS commits to the Achievable Benchmark of Care (ABC™) methodology for assigning benchmarks within public reporting.
  4. We can know when to expect each publicly reported measure to debut on Physician Compare.


Physician Compare now includes Star Ratings

CMS has invested significant time and resources into making Physician Compare a valuable tool that enables consumers to make educated healthcare decisions and encourages them to hold healthcare providers accountable for the quality of care they deliver. One way to achieve the first objective is to make publicly reported information accessible and understandable to users. With the progressive incorporation of Star Ratings, CMS has stated, “Star Ratings make it easier for consumers to use the information on the Compare Web sites and spotlight excellence in healthcare quality.” Any measure that is eligible for public reporting at the medical group level will have a Star Rating attached to it. The number of stars assigned corresponds directly to the measure’s score. For clinical measures, that would be the percentage of occurrences. For CAHPS for PQRS measures, it would be the percent top box. Each star represents 20%, so an item scoring 90% would earn 4.5 stars.

CMS is publishing CAHPS scores for groups and ACOs that participated in 2014

PRC has conducted CAHPS for ACOs studies as an approved survey vendor since 2013 and CAHPS for PQRS studies as an approved survey vendor since 2015. These two programs are electing to publish results on the Physician Compare website in slightly different manners, although both programs collapse individual questions’ responses into composite measures.

Accountable Care Organizations occupy a distinct section of Physician Compare and report Patient Experience of Care measures as linear mean scores. Currently, the website shows four of the potential 12 CAHPS for ACOs measures.

Conversely, the Physician Quality Reporting System measures are reported at the group level, and the CAHPS for PQRS scores are shown under the “Survey of patients’ experiences” tab. This program publishes top box scores for the composites and displays Star Ratings as previously mentioned. Eight of the 12 CAHPS for PQRS measures are currently displayed for the 2014 reporting period.

ABC™ methodology will be used for assigning benchmarks

In today’s atmosphere of market research and consumer assessments, there always has to be a definition of what distinguishes “excellent” from “okay.” CMS acknowledges the value and urgency of benchmarking for the data it publishes. CMS has determined that the Achievable Benchmark of Care methodology is the most appropriate strategy for identifying national goals. In short, the ABC is the mean of the best performers on a measure for at least 10% of the patient population.

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There will be a different benchmark for each measure, but in the case of the clinical items, there will also be different benchmarks per reporting mechanism (Registry, EHR, GPRO, etc.). At this time, CMS has neither finalized how benchmarks will be displayed in Physician Compare nor defined the relationship they’ll have with the Star Ratings. These innovative benchmarks will not be available online until Fall 2017, at the earliest.

We can know when to expect each publicly reported measure to debut on Physician Compare

The timeline for the rollouts of these measures has been announced. Naturally, it is subject to change, but it is always valuable to get a glimpse of CMS’s plans in advance. You’ll see below that we are in the third column, where 2014 results are available. Each year will reveal a few more measures or features.

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It is important to note that the summary scores achieved by medical groups will not be displayed on individual providers’ pages. Also, anything that is unique to a provider will not be linked to or displayed on the group’s page. For more information on what measures will be displayed when and where, see the Public Reporting Outline.

For more information directly from CMS, visit the Physician Compare Initiative Page or reach out to the Physician Compare Support Team.