On December 10, the Centers for Medicare & Medicaid Services (CMS) added new quality data to the Physician Compare and Hospital Compare websites. Both websites allow healthcare consumers – both patients and health plans – to compare providers’ performance on objective quality measures.
While not there yet, CMS intends to make the two websites as user-friendly as the Star Rating System for Medicare Advantage and Prescription Drug Plans. And, in the case of Physician Compare, the implementation of the physician Merit-Based Incentive Payment System over the next three years will deliver a wealth of new data with which consumers can compare providers.
Physician Compare
Until last year, the data available on Physician Compare was limited to basic contact information. In February 2014, CMS included the first quality measures for group practices. Now, CMS has significantly expanded the list of measures and – for the first time – included a subset of quality measures for individual healthcare professionals. Also, measures for Shared Savings Program and Pioneer ACOs now are available on Physician Compare.
To make the information user-friendly for consumers, performance scores on each measure for group practices and individual providers are displayed as stars, with each star representing 20%. If, for example, a group practice scores 80% on a measure, four fully-filled stars would be displayed.
For now, these stars do not represent a rating or ranking system because they do not serve to benchmark or compare providers against one another. And, for now, the website does not allow a beneficiary to make a side-by-side comparison of providers based on performance scores. CMS, however, intends to add benchmarking and performance-score comparisons to Physician Compare by 2017.
Hospital Compare
Today, Hospital Compare includes information on more than 100 quality measures and over 4,000 hospitals. These include individual hospital’s scores on the Medicare hospital readmission reduction program, the value-based purchasing program, and hospital-acquired condition reduction program.
Hospital Compare also includes hospital star ratings based on patient satisfaction survey scores. A beneficiary can compare one hospital against another with regard to measures such as communication with physicians and nursing staff, effective pain control, and cleanliness. CMS now is working to expand the hospital star ratings to include other key performance measures.
If the Medicare Advantage star rating system is any indication, a provider’s rating will have a significant impact on beneficiary decision-making. In 2015, 61% of Medicare Advantage beneficiaries selected a 4-star or higher plan, up from 23% in 2010. Providers, therefore, should stay abreast of CMS’ plans to make more performance scores publicly available and to benchmark providers’ performance against each other.
More importantly, providers should be identifying and pursuing opportunities for improvement in their performance scores. In the very near future, these scores will be a key factor in determining market share, as more healthcare consumers – patients and health plans – come to rely on comparative ratings to make buying decisions.
