Assessing physician performance and quality-of-care is a critical component of the move to greater accountability and improved value in health care.
What's the Issue?
Surveys show consumers have high interest in information that helps them evaluate and choose physicians. Insurers, employers and government are increasingly tracking physician performance—for quality improvement, network creation, contract negotiations, and payment incentive initiatives.
The federal government has now entered this realm with the launch of Physician Compare, a website mandated by the Affordable Care Act (ACA). Physician Compare follows in the tradition of, and will be cousin to, Hospital Compare, Nursing Home Compare, Home Health Compare, and Dialysis Facility Compare. Those earlier-established sites and the data they present have evolved significantly over the past decade, and now encompass thousands of facilities nationwide, including every acute care hospital in the nation and almost 16,000 nursing homes.
The sites are credited with advancing accountability and motivating improvements in care and quality. But they are also widely viewed as poorly organized and inadequately audited when the data is submitted by facilities. As a result, the sites are not as impactful or widely used as they could be, especially by Medicare beneficiaries and other consumers. Under the ACA and subsequent legislation, CMS is required to improve these public accountability initiatives. For example, in 2015 CMS will present 5-star ratings of hospitals, based initially on measures of patient experience. In addition, starting next year more nursing home data will be submitted electronically and audited.
Physician Compare is being developed amid these positive changes. This brief focuses on Physician Compare’s evolution to date and current trajectory. It does not present a full discussion of the issues surrounding physician quality measurement or the public reporting of quality and cost information.
Physician Compare is a work in progress. It has the potential to be an important source of information and empowerment for consumers and a significant driver of choice, competition, and health care improvement. CMS has learned much in recent years through its management of Hospital Compare and its affiliated sites, and the launch of the insurance plan comparison site healthcare.gov. But many obstacles remain. The posting of clinical quality and outcome measures will raise the stakes for physicians, and it’s unlikely that there will be easy agreement on how Physician Compare should roll out in 2015 and beyond. Absent aggressive marketing by the government, the site likely won’t reach a wide audience for years to come.