The Centers for Medicare and Medicaid Services is weighing what quality measures to use for a website it is developing to help consumers compare physicians, an offering that is required under the health reform law enacted earlier this year.
The "Physician Compare" website, fashioned after the existing CMS "Hospital Compare" site that enables consumers to shop for hospitals against several price and quality factors, will be launched by Jan. 1, 2011, says CMS.
Initially, CMS will post information about physicians enrolled in the Medicare program and those participating in the Physician Quality Reporting System (PQRS), through which CMS pays incentives for providers who meet various quality marks. CMS will add in January 2013 physician performance information based on 2012 quality reporting it receives.
Both physicians and consumers have concerns about how the website is designed.
"There's a lot of interest and opportunity but also some anxiety about it and how it will come out," said Michael Rapp, MD, director of the quality measurement and health assessment group in CMS' Office of Clinical Standards and Quality, who spoke at a town-hall meeting Oct. 27 about the website's development.
In general, physician organizations are anxious to have performance information about them risk-adjusted for clinicians who treat more seriously ill patients or patients with multiple conditions versus those who do not so the numbers will not be weighted against them.
In general, the medical community supports the use of performance metrics. At the same time, doctors want "responsible public reporting that is based on actionable, current, clinically sound, and scientifically valid reporting measures," according to a representative of the American College of Cardiologists.
Meanwhile, consumers want measures they can easily understand and use. Steven Findlay, senior health policy analyst at Consumers Union, proposed "using a core set of meaningful measures for the consumer's own care."
For example, instead of listing medical processes used in treating and tracking diabetes, Findlay suggested that physicians report diabetes measures as a composite.
Currently, CMS publishes a directory of Medicare providers by specialty and location. CMS will use its "physician finder" directory as a foundation for Physician Compare, according to Regina Reymann Chell, health insurance specialist in tbe CMS Office of Clinical Standards and Quality.
According to the Patient Protection and Affordable Care Act, CMS should include in the website measures of patient health outcomes collected through PQRS assessments.
CMS is exploring how physicians could review their results before they are made public and processes that should be established to ensure accurate data about physicians' performance, according to Reymann Chell.