The CMS Physician Compare website has limited datasets, calling into question its efficacy at demonstrating patient experience and care quality.
The Medicare Physician Compare website may not be an accurate portrayal of healthcare quality, with limited datasets impeding a patient’s ability to use the tool to make healthcare decisions, according to a group of researchers from the University of Michigan.
CMS developed Physician Compare with the intention that patients would use the online tool to compare clinical quality and patient experience data about different physicians providing care to Medicare beneficiaries. The tool aimed to make this information simple and digestible for patients in order to allow them to understand the decision they were making.
“The website is in its final phase of expansion, the focus of which has been the addition of clinician-level performance data to existing practice-level data, to further help patients and their caregivers choose high-quality clinicians,” the researchers reported in their paper.
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But the study, which looked at data from the Physician Compare National Downloadable File and the 2015 Medicare Data on Provider Practice and Specialty database, found that Physician Compare may fall short of those intentions.
Specifically, the data presented on Physician Compare may not be robust enough to provide an accurate picture of patient experience and clinical care quality. After all, participation in Physician Compare is voluntary, the researchers noted, meaning a number of providers may opt out of the public reporting portion of Medicare programs.
Specifically, Physician Compare houses quality information about less than one-quarter of all clinicians providing care to Medicare beneficiaries. Only about 1 percent of all providers participating in Physician Compare have volunteered clinician-level data, meaning they have not opted into this final leg of the Physician Compare development.
“This study is important for two reasons,” Jun Li, a doctoral candidate in the Health Management and Policy at UM School of Public Health and lead study author, said in a statement. “First, patients and caregivers want information to be able to make informed choices. Thus, it is important to determine whether that need is being met. Additionally, federal policymakers are expending a great deal of resources toward Physician Compare, therefore it is imperative that we know how well it is functioning and whether it needs to be improved.”
The Physician Compare website is not a strong source of clinician-level quality information and may not be reliable for patient decision-making, the researchers concluded. CMS leaders may reconsider their approach to soliciting physician information to populate the website. Additionally, a redesign of the Physician Compare website may make the information CMS already has more usable for patients.
This is not the first time researchers have questioned the accuracy of websites promoting clinical quality data transparency. As consumerism becomes more present in healthcare, industry leaders are contending with various online platforms on which patients may collect information about a provider, hospital, or payer.
Although the CMS Physician Compare website, along with its Hospital and Medicare Star Ratings, are intended to be a solid source of information for patients during care decision-making, the fact of the matter is these platforms are not always useful, researchers have found.
In addition to the dearth of information the UM researchers found, other investigations have revealed that few patients are even tapping into these resources. A 2018 survey from HealthMine found that only about one-fifth of Medicare Advantage beneficiaries use the Medicare Star Ratings to make decisions about plan enrollment.
Other key experts believe the Star Ratings lack essential data, such as information about the social determinants of health. Risk adjusting scores could give patients a better idea of how a provider or hospital cares for patients.
Ultimately, no reflection of clinical quality information is going to be perfect, especially as the medical industry is only just beginning to engage in consumer-driven healthcare. As more providers adjust to this level of care quality transparency and CMS continues to refine its efforts to drive healthcare transparency, its systems for patient-centricity will have to iterate and account for more robust data.
Date: May 17, 2019
Source: Patient Engagement HIT