Do you have 5 stars? CMS rolls out individual scores on Physician Compare: 5 things to know

Written by Laura Dyrda | December 14, 2015 | Print  |

Medicare introduced performance scores for six quality-of-care measures for clinicians on its Physician Compare website last week, giving patients the opportunity to see how many "stars" individual physicians have, according to a Medscape report.

The Physician Compare data covers 400,000 individual clinicians. The individual performance measures include:


• Screening for unhealthy body weight and developing a follow-up plan
• Screening for tobacco use and providing help on quitting
• Screening for high blood pressure and follow-up plans
• Screening for depression and follow-up plan development
• Comparing new and old medications
• Using aspirin or prescription medication for heart attack and stroke reduction


The stars are designed as "consumer product ratings" previously limited to group practices and accountable care organizations. The data is calculated based on claims data and each star represents 20 percent compliance. Here are five key notes on the stars:


1. Not all clinicians report the same PQRS metrics and some metrics aren't reportable for some physicians. The Physician Compare website includes a cautionary note to avoid misunderstandings.


2. The absence of performance scores for a measure could mean the clinician didn't participate in the PQRS program in 2014.


3. The star system isn't designed to compare clinicians on quality, according to a CMS statement. However, AMA President Steven Stack, MD, is concerned visitors to the website might not pay attention to CMS's cautions and become confused.


4. There were accuracy issues with the 2014 PQRS calculations, which factor into the star ratings as well.


5. Based on their data, the clinicians can receive up to five full or partial stars on a measure.


"Given the wide spread accuracy issues with the 2014 PQRS calculations, the newly released information is premature," said Dr. Stack. "The data inaccuracies and difficulties with CMS' processes grew over the last couple of months, and while CMS has acknowledged these problems, it has failed to address the underlying issues. Most importantly, consumers visiting the Physician Compare website are likely to get a false impression that it provides accurate information for all physicians, when, in fact, due to significant data problems, the newly added information covers only about 400,000 physicians."


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