Alesia: Hello and welcome to the public reporting
on Physician Compare webinar.
I'm Alesia Hovatter, Health Policy Analyst in the Division of
Electronic and Clinician Quality in the Quality Measurement and
Value-Based Incentives Group, otherwise known as QMVIG.
in the Center for Clinical Standards
and Quality at the Centers for Medicare and Medicaid services,
also known as CMS.
QMVIG is responsible for evaluating and supporting
the implementation of quality measure programs.
These programs aim to assess health care quality in a broad
range of settings, such as hospitals, clinicians' offices,
nursing homes, home health agencies
and dialysis facilities.
Our group actively works with many stakeholders to promote
widespread participation in the quality measurement,
development and consensus process.
I'll be joined today by two members of
the Physician Compare support team,
Lisa Lentz and Allison Newsom.
Next slide, please. This is our disclaimer slide.
I'll let you read over it at your convenience.
Now, we're on slide three,
which is acronyms in this presentation.
This is just a helpful guide for
acronyms that we'll be using today.
Next slide, please.
We're on slide number four now.
The purpose of today's session is to provide
a brief overview of Physician Compare,
share information about public reporting of the
merit-based incentive payment system, known as MIPS, and the
Alternative Payment Model, known as APMs, and discuss some next
steps for Physician Compare and public reporting.
During the last half-hour of the webinar,
we will open the lines and members of our team
will answer questions.
Lisa Lentz: Great,
thank you Alesia and good afternoon everyone.
I'll now provide an overview of Physician Compare.
Before I do, though,
I want to acknowledge that we have a diverse audience on the
line today in terms of their familiarity with Physician
Compare. For that reason I will do my best to cover this in such
a way that works for everyone, whether you're joining us for
the first time and are new to Physician Compare or whether
you're very familiar with the site already.
If you do have questions,
you will have a chance to ask them at the
end of the presentation.
CMS established Physician Compare as
required by Section 10331 of the Patient Protection and
Affordable Care Act or ACA.
As a result of ACA the site launched
on December 30th, 2010.
The Medicare and CHIP Reauthorization Act,
or MACRA, passed in 2015 and provided
additional direction for the website.
Physician Compare is a website that
lists information about clinicians, groups and
Accountable Care Organizations or ACOs.
As you'll see here on the slides,
Physician Compare has a dual purpose.
It helps people with Medicare make informed healthcare
decisions. It also incentivizes clinicians
and groups to maximize their performance.
One of the frequently asked questions we
get about Physician Compare is what are the criteria to be
listed on the website?
To be listed on Physician Compare,
both clinicians and groups must be approved in the Provider
Enrollment, Chain, and Ownership System, PECOS, which is the sole
verified source of Medicare provider information.
They also need to have at least one practice location,
and in the last six months, have submitted a Medicare fee
for service claims or be newly enrolled in PECOS.
Additionally, clinicians must have at least
one specialty listed in PECOS and groups must
have a legal business name and at least two active Medicare
clinicians reassign their benefits to the group's
tax ID number or TIN.
We did also want to note that for ACOs to be
included on the site,
they must have performance information from 2016.
On this slide, we'll see here is the general information
that is on Physician Compare for clinicians and groups.
For both clinicians and groups, we list name, address,
phone numbers, medical specialties, Medicare assignment
status, that is, whether or not a clinician accepts the
Medicare-approved payment amount.
Then, for clinicians, we
also include board certification, education,
residency, gender, group, and hospital affiliation.
For groups,
we also have information about affiliated clinicians or
clinicians that practice as a part of that group.
The affiliated clinicians determine the groups'
specialties and ACO affiliation.
For ACOs we have a little bit more basic information
than we do for clinicians and groups, as we are
able to link directly to the ACO web pages.
Much of the general information we post on Physician
Compare comes from PECOS, names,
locations, phone numbers, group affiliation, specialties,
Medicare assignment status, education, and gender.
We also use claims data to verify information, such as
practice location and group affiliation,
that we received from PECOS as well as using
claims data for hospital affiliation.
We also currently have information available from four
boards listed on the website.
Those boards include the American Board of
Medical Specialties, the American Osteopathic
Association, American Board of Optometry, and the American
Board of Wound Medicine and Surgery.
Because we use a lot of
information from PECOS to populate Physician Compare, it's
very important to keep that information in PECOS up to date.
It could take up to two to four months for changes to appear on
Physician Compare after they are updated in PECOS.
We invite you to visit the Physician Compare Initiative
page to learn more about which fields in PECOS are
driven for website populations.
If you have more information or any specific questions about
updating your information, please don't hesitate to contact
us at PhysicianCompare@Westat.com.
Also, just to give more context about the public reporting of
performance information on Physician Compare, we wanted to
show this roadmap.
Beginning in February 2014, we publicly
reported a subset of 2012 group PQRS, or physician quality
reporting system measures, as well as some ACO measures.
Since then, every December, we publicly report the previous
year's data as part of our continued phased approach to
public reporting. For example, in December 2015,
we publicly reported 2014 data for groups and ACOs.
In addition, this is also the first time
we reported clinician level data.
In 2016 we reported program information submitted through
qualified clinical data registries,
or QCDRs, for the first time as well.
This past December we added 2016 performance
information and this was also our first time reporting measure
level, star ratings, for a subset of the 2016 group PQRS
measures. Looking ahead in late 2018, we will add 2017 Quality
Payment Program information to the site.
We'll discuss this in more detail
as we go through the rest of the presentation.
At this time I'd like to pass the presentation over to
Allison Newsom who will walk through the public reporting
with the Quality Payment Program.
Allison Newsom: Thanks so much, Lisa.
The Medicare and CHIP Reauthorization Act, or MACRA,
and the creation of the Quality Payment Program provided some
additional direction for public reporting on Physician Compare.
In this next section,
I'll discuss information on how the Quality Payment Program
may be publicly reported on Physician Compare.
First, some background about the Quality Payment Program.
Under the Quality Payment Program, there are two
tracks in which clinicians may participate.
The first is the
merit-based incentive payment system or MIPS.
The second is called Advanced Alternative
Payment Models or Advanced APMs.
Certain clinician types are eligible to participate in the
Quality Payment Program.
There are also some additional
requirements that clinicians must meet in order to
be able to participate.
There's a link on this slide to learn more about
clinicians that were eligible to participate in 2017.
If you have any questions about this, we recommend that you
reach out to the Quality Payment Program directly.
Their contact information is included at the end
of this presentation.
Year one of the Quality Payment Program data are the
2017 performance period data.
Those data are available for public
reporting on Physician Compare starting in late 2018.
All data that goes on Physician Compare must meet the
established public reporting requirements to be included on
the site unless otherwise required by statute.
Data must be statistically valid, reliable, and accurate,
and it must be comparable across submission
mechanisms and meet the minimum reliability threshold.
Additionally, to be included on the public facing
profile pages, data must prove to resonate with patients
and caregivers as shown through user testing.
I just want to point out that first-year measures
will not be publicly reported on Physician Compare in 2018.
Additionally, voluntary data reported in 2017 will not be
posted on the site for 2018.
When I say voluntary data
I'm referring to data reported by clinicians who were not
considered to be eligible clinicians for 2017.
This slide shows the 2017 MIPS information that are
technically available for public reporting for groups
and clinicians later this year.
The four categories are quality, cost, Improvement Activities,
and Advancing Care Information, which for year two is now known
as promoting interoperability.
In the next few slides,
we'll share more information about how these categories
may be publicly reported.
I also wanted to call out that, although these data
are considered available for public reporting, not all data
will be publicly reported on the site this year.
In addition to the four categories,
we'll also have information about
clinicians' performance category scores and their final scores,
as well as we will be publicly reporting aggregate MIPS
information, which will include the range of final scores for
all MIPS eligible clinicians and the range of performance for all
MIPS eligible clinicians within each performance category.
For the quality category, we're tracking to all collection types
being available for public reporting.
Only one collection type
per measure will be made public at this time.
This is to meet our public reporting standard that data
must be comparable.
We want to be sure that variations in score are
due to actual variations in performance, not due to the
collection types or maybe there are some variations in the
specifications for those.
The following measure types will not
be publicly reported in 2018.
Again, we will not be publicly
reporting first-year measures nor will we be publicly
reporting non-proportional measures, so continuous or ratio
measures, or non risk-adjusted outcome measures.
For MIPS quality measures, we expect to publicly report a
subset of the 2017 data in late 2018.
We're tracking to publicly reporting
these measures as star ratings.
Measures that are reported as star ratings
must meet the established public reporting standards,
and then additionally they must meet an additional
level of reliability testing.
The star rating cutoff and
the star ratings must prove to be reliable.
The image on this slide is an example of
how we are currently publicly reporting the quality measures.
You can see here that we've got plain language
measure title and a plain language measure description,
either written in a way that is meant to be
understandable and meaningful to our main website users,
which is Medicare beneficiaries and caregivers.
You also see an example of a star rating for quality measure.
This is just an example of what the data may look like
when it goes up on Physician Compare later this year.
We're using the 2016 measures as an example.
If you are interested in learning more
about the star ratings for MIPS quality measures, we have a
benchmark and star ratings fact sheet that's available on the
Physician Compare Initiative page.
If you click this link on the slides
when you get them, it will take you right there.
I highly recommend that you look at that.
In addition to the MIPS quality measures,
we're also tracking to publicly reporting
QCDR and CAHPS for MIPS measures.
We wont be publicly reporting those as star
ratings at this time. For QCDR measures,
we're reporting them as a percent performance score.
For the CAHPS for MIPS measures,
we'll be reporting them as a top box score.
This is the Agency for Healthcare Research
and Quality, or AHRQ's, suggested method for
publicly reporting CAHPS scores.
We've also seen, from previous user testing,
that this way of publicly reporting the measures
is well understood by consumers. Again, on this slide, you're
seeing an example of what the scores would look like on
Physician Compare using the 2016 data.
We expect the 2017 data going up
later this year to look similar to this.
The next category under MIPS is Improvement Activities.
At this time, we are not tracking to publicly reporting
any Improvement Activities later this year because all of the
2017 performance year Improvement Activities are
considered to be first-year activities and therefore not
available for public reporting.
In future years, all improvement
activities are available for public reporting and we're
evaluating how those will be publicly reported on the site.
Next up is Advancing Care Information, which I mentioned
is known as promoting interoperability for year two.
Advancing Care Information may be publicly reported on the site
in up to three different ways,
the first of which is that clinician and
group profile pages will have an indicator for satisfactory
and high ACI performance as technically feasible.
ACI attestations may be
reported on clinician and group profile pages using check marks
and plain language descriptions.
ACI measures are available for
public reporting if they meet the established
public reporting standards.
Similar to the other categories, first-year ACI measures
and attestations are not available for public reporting.
We're not targeting to publicly report cost data in
2018 as it's not being used for scoring in the first year.
The Physician Compare support team is continuing to evaluate
ways to publicly report this performance category in future
years and will be sure to share more information with
About this with you as it's available.
In addition to publicly reporting information and
profile pages, we're also tracking to reporting
performance information in the downloadable database.
Performance information that meets
all statistical public reporting standards but does not
resonate with website users will be added to the Physician
Compare downloadable database. Our reasoning behind this is
that the profile pages are intended for use by Medicare
beneficiaries and their caregivers.
Meanwhile, the downloadable database has a primary
audience of people like researchers clinicians or others
who are interested in digging more into the data,
and so we have some additional information
available in that downloadable database.
Also, MACRA requires
that we publicly report utilization data, so currently
we're publicly reporting a subset of the 2015 utilization
data in the Physician Compare downloadable database.
When we update the downloadable database to include the 2017
performance data, we'll also be updating it to include
a subset of the 2016 utilization data,
which is what's most recently available at that time.
Moving on from the four MIPS categories,
we're now shifting gears to talk about Alternative
Payment Models or APMs.
Beginning in late 2018,
Physician Compare is targeting to publicly report information
about 2017 APM participation as technically feasible.
Clinician and group profile pages will have an indicator
that they participated in the Quality Payment Program.
We'll also link clinicians and groups to APM
profile pages for selected advanced APMs and Shared Savings
Program or SSP Track One ACOs.
At this time we're still assessing which APM performance
information meets our public reporting criteria
and will be publicly reported later this year.
That was a quick overview of how we will be publicly
reporting the 2017 Quality Payment Program performance
information on Physician Compare.
Now, I'd like to talk about what you can expect
in the coming months.
In fall of 2018 we'll be previewing the 2017 performance
information during our Physician Compare preview period.
The preview period is intended to give clinicians and
groups a chance to see what their performance data
will look like before it's publicly reported on
Physician Compare profile pages later this year and in the
downloadable database when it's made publicly available.
During this fall,
we'll be hosting a National Provider Call.
At this time we'll share more information about the specific
2017 measures targeted for preview
and public reporting in late 2018.
We'll share an official date for the
NPC as it is available.
Again, during this National Provider
Call, this is when we'll be sharing materials about how to
access the preview period as well as detailed documentation
about the specific measures and attestations that will be available
for preview and then for public reporting later this year.
The 2019 Medicare Quality Payment Program Proposed
Rule is currently out for public comment.
Because we're in active rule making, we're unable to
discuss the proposals at this time.
However, we do want to encourage you
to review the Proposed Rule and submit public
comment by September 10th 2018.
You can use the link on this slide
to access the Proposed Rule.
As I've mentioned multiple times
throughout the presentation, there's a lot more
coming for Physician Compare in the next few months.
We want to make sure that we are staying engaged
with you and are able to share this information.
One way to keep in touch with us is to
sign up to receive the Physician Compare e-news.
You can use the link on this slide to do that.
Another way is to continue to
engage with us about the future of Physician Compare.
So If you're an interested clinician or a group
representative and you want to talk to us about the future of
Physician Compare in one-on- one or small group discussions,
please contact us at PhysicianCompare@Westat. com.
We would love to hear from you.
That concludes today's presentation
portion of the webinar.
I 'm now going to pass things over to my colleague
Laura to facilitate the Question and Answer session.
Laura: Thanks, Allison.
We are now going to stop the recording of
today's presentation and begin our Question and Answer session.
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