Physician Compare Public Reporting Information Session Alesia Hovatter Health Policy Analyst Division of Electronic and Clinician Quality Quality Measurement and Value-Based Incentives Group Center for Clinical Standards and Quality Centers for Medicare & Medicaid Services October 2016
Disclaimers This presentation was current at the time it was published or uploaded onto the web. Medicare policy changes frequently so links to the source documents have been provided within the document for your reference. This presentation was prepared as a service to the public and is not intended to grant rights or impose obligations. This presentation may contain references or links to statutes, regulations, or other policy materials. The information provided is only intended to be a general summary. It is not intended to take the place of either the written law or regulations. We encourage readers to review the specific statutes, regulations, and other interpretive materials for a full and accurate statement of their contents. 2
Agenda • Physician Compare background & overview • 2015 performance scores on Physician Compare in late 2016 • Physician Compare preview period • Question & answer 3
Housekeeping • Question & answer – Raise your hand – Type a question • Questions? Contact us at PhysicianCompare@Westat.com 4
Physician Compare Background & Overview 5
Background 6
Public reporting overview February December December 2014 2014 2015 5 4 2013 PQRS GPRO 14 2012 PQRS GPRO 2014 PQRS GPRO measures collected via measures collected via measures collected via Web Interface (WI) Web Interface (WI) Web Interface (WI) 8 2014 CAHPS for PQRS Group summary survey measures practices 139 66 343 group practices group practices group practices 6 2014 PQRS measures collected via claims Individual clinicians 37k individual clinicians 5 8 18 2013 ACO measures 2014 ACO measures 2012 ACO measures Accountable Care 353 141 237 Organizations Shared Savings Shared Savings Shared Savings Program and Program and Program and Pioneer ACOs Pioneer ACOs Pioneer ACOs 7
Public reporting plan Publicly reported in Targeted for public reporting in Available for public reporting in December Late 2016 Late 2017 2015 All 91 * 14 2015 PQRS GPRO 2016 PQRS GPRO 2014 PQRS GPRO measures collected via measures collected via any measures collected via Web Interface or registry reporting mechanism Web Interface 8 8 12 2015 CAHPS for PQRS 2016 CAHPS for PQRS 2014 CAHPS for PQRS summary survey measures summary survey measures summary survey measures Group practices All 2016 PQRS and non-PQRS QCDR measures I t e m - l e v e l b e n c h m a r k All 6 90 * 2016 PQRS measures 2015 PQRS measures 2014 PQRS measures collected via any reporting collected via Web collected via claims mechanism Interface or registry Individual All 16 * 2016 PQRS and non-PQRS 2015 non-PQRS clinicians QCDR measures QCDR measures I t e m - l e v e l b e n c h m a r k Accountable 18 All 2014 Shared Savings 22 2015 Shared Savings 2016 Shared Savings Care Program and Pioneer Program and Pioneer Program and Pioneer Organizations ACO quality measures ACO quality measures ACO quality measures *Additional measures will be publicly reported via the Physician Compare Downloadable Database. 8
Medicare Access and CHIP Reauthorization Act (MACRA) • Medicare Quality Payment Program – Merit-Based Incentive Payment System (MIPS) • Quality • Cost • Performance improvement • Advancing care information – Advanced Alternative Payment Models (Advanced APMs) 9
2015 Performance Scores on Physician Compare in Late 2016 10
Public reporting standards 11
2015 measures targeted for public reporting in late 2016 12
Measure categories 13
Performance scores on Physician Compare 14
Performance scores on Physician Compare 15
Physician Compare Preview Period 16
Physician Compare Lookup tool https://www.qualitynet.org/portal/server.pt/community/lookup 17
PQRS and Provider Quality Information Portals 18
PQRS and Provider Quality Information Portals 19
PQRS and Provider Quality Information Portals 20
PQRS and Provider Quality Information Portals 21
Provider Quality Information Portal (PQIP) 22
Need more help? • Use the Guide to Physician Compare Preview Period for more detailed instructions. • For EIDM and PQIP registration assistance, contact the QualityNet Help Desk. 866-288-8912, TTY: 877- 715-6222, qnetsupport@hcqis.org. • For questions about Physician Compare, the preview period , or performance scores , visit the Physician Compare Initiative page or contact us at PhysicianCompare@Westat.com. 23
Question & answer • Question & answer – Raise your hand – Type a question • Questions? Contact us at PhysicianCompare@Westat.com 24
For More Information • Please direct inquiries regarding Physician Compare to PhysicianCompare@Westat.com. • Find additional information at CMS.gov – Search for “Physician Compare,” or – Go directly to the Physician Compare Initiative page. 25
Resources 26
Useful links • Physician Compare website • Physician Compare Initiative page – Guide to Physician Compare Preview Period – Physician Compare 2015 Clinician Measures – Physician Compare 2015 Group Measures – Downloadable Database 2015 Clinician Measures – Downloadable Database 2015 Group Measures • Downloadable database • Quality Payment Program 27
Acronyms • • ACA – Affordable Care Act MACRA – Medicare Access and CHIP Reauthorization Act • ACO – Accountable Care • Organization MIPS - The Merit-based Incentive Payment System • APM – Alternative Payment • Model NPI – National Provider Identification Number • CAHPS – Consumer Assessment • of Healthcare Providers and TIN – Tax Identification Number Systems • PQIP – Provider Quality • CMS – Centers for Medicare & Information Portal Medicaid Services • PQRS – Physician Quality • EIDM – Enterprise Identity Reporting System Management • QCDR – Qualified clinical data • GPRO – Group Practice registry Reporting Option • QPP – Quality Payment Program 28
Contact information • Physician Compare support team – PhysicianCompare@Westat.com • QualityNet Help Desk– 866-288-8912, TTY: 877-715-6222, qnetsupport@hcqis.org • Quality Payment Program – QPP@cms.hhs.gov 29
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