Physician Compare is a website that allows consumers to search for and obtain information about physicians and other health care professionals who provide Medicare services.
What Is Physician Compare?
The Patient Protection and Affordable Care Act (ACA) required the Centers for Medicare and Medicaid Services (CMS) to establish the Physician Compare website. As a result, the site was launched on Dec. 30, 2010. This site has a twofold purpose: 1) to provide information for consumers to encourage informed health care decisions; and 2) to create explicit incentives for physicians to maximize performance.
What Information Is Currently Available on Physician Compare?
Some of the information currently on the site includes:
- Physicians' names, addresses, where they see patients, and phone numbers
- Primary and secondary specialties
- Professional school attended and year of graduation
- Gender
- If physicians speak languages other than English
- If physicians accept Medicare assignment
- Successful participation in the Physician Quality Reporting System (PQRS)
- Successful participation in the Electronic Health Record (EHR) Incentive Program
- Hospital affiliation
- Group affiliation
How Are CMS' Quality Programs Related to Physician Compare?
Physician Compare includes information about physicians who satisfactorily participate in CMS quality programs. The Physician Quality Reporting System is a pay-for-reporting program that gives eligible professionals incentives and payment adjustments if they report quality measures satisfactorily. Although PQRS is a stand-alone program, it touches on other CMS programs that require quality reporting, such as the EHR Incentive Program and the Value-Based Payment Modifier.
This Medicare program encourages physicians to report information about the quality of the care they provide to people with Medicare who have certain medical conditions. Physicians can choose whether to report quality information through PQRS. Profile pages show whether physicians have successfully taken part in PQRS.
The Electronic Health Record Incentive Program is a Medicare program that provides incentives and payment adjustments to eligible professionals who use certified EHR technology in ways that may improve health care. Profile pages will show if physicians are successfully participating in the EHR Incentive Program.
What Information Will Be Added to Physician Compare in the Future?
CMS has begun to implement a plan to make quality data available on Physician Compare. In the future, Physician Compare profiles will include information such as:
- The measures collected under the Physician Quality Reporting System
- An assessment of patient health outcomes and functional status of patients
- An assessment of the continuity and coordination of care, as well as care transitions
- An assessment of efficiency
- An assessment of patient experience and patient, caregiver, and family engagement
- An assessment of the safety, effectiveness and timeliness of care
Please note this data will reflect the care provided to all patients seen by physicians under both the Medicare program and other payers (to the extent such information would provide a more accurate portrayal of physician performance).
The plan for Physician Compare also includes publicly reporting patient experience data, such as the Consumer Assessment of Healthcare Providers and Systems (CAHPS) measures, for group practices of two or more eligible professionals. These measures include patient evaluation of variables such as:
- Getting timely care, appointments and information
- How well providers communicate
- Patient's rating of provider
- Access to specialists
- Health promotion and education
- Shared decision-making
- Health status / functional status
- Courteous and helpful office staff
- Care coordination
- Between-visit communication
CMS will also be posting a list of individual physicians who satisfactorily report under PQRS (in addition to this being noted on the physician profiles).
Where Does Physician Compare Get Its Information?
The underlying database on Physician Compare is generated from PECOS [the Provider Enrollment Chain and Ownership System], as well as fee-for-service claims. Therefore, it is critical that DCs ensure their information is up-to-date and as complete as possible in the national PECOS database. (To update information not found in PECOS, providers should contact the Physician Compare support team.)
The current members of the Summit Subcommittee on Documentation are Dr. Frank Nicchi, Ms. Susan McClelland, Dr. Steven Kraus, Dr. Salvatore LaRusso, Dr. Peter Martin, Mr. Robert Moberg and Mr. David O'Bryon. Ms. McClelland served as principal author of this article.