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Practice Fusion · Aug 19, 2016

Ensure your information on Medicare Physician Compare is up to date

If you’re a provider that accepts Medicare patients, it’s likely you’re one of the 6 in 10 providers that have your information listed on Physician Compare, a website created by the Centers for Medicare and Medicaid Services (CMS). According to CMS, Physician Compare is designed to help patients find information they need to make decisions about their health care. Increasingly this includes information about providers.

Currently, patients can use the Physician Compare website to view information about providers that accept Medicare patients, such as:

Individual provider information

  • Name
  • Medicare specialties
  • Practice location(s)
  • Group affiliation(s)
  • Hospital affiliation(s)
  • Medicare assignment status
  • Education
  • Residency
  • ABMS specialty
  • Board certification

Group practice information

  • Practice name
  • Practice specialties
  • Practice location(s)
  • Medicare assignment status
  • Affiliated professionals

Providers and group practices that successfully participated in a CMS quality program have a green check mark on their profile page to indicate their commitment to quality.

Ensure your information is up to date

Providers can login to the Physician Compare site to verify their information and the information for their practice.

Verify your information on Physician Compare

If anything listed is incorrect, you can submit a request to CMS.

The information available through Physician Compare will likely increase

As outlined in its proposed rule for the Quality Payment Program, CMS intends to increase the amount of provider and practice information on the website as well as introducing the ability to directly compare physicians and other healthcare professionals. Additionally, CMS is proposing a process for public reporting of a MIPS eligible clinician’s data information through Physician Compare. The following information would be accessible for individual MIPS eligible clinicians and groups:

  • The MIPS eligible clinician’s CPS (Current Population Survey’s).
  • The MIPS eligible clinician’s performance under each MIPS performance category (quality, resource use, CPIA and advancing care information).
  • Names of eligible clinician’s in APMs and, to the extent feasible, the names of such APMs and the performance of such models.
  • Periodically post aggregate information on the MIPS, including the range of composite scores for all MIPS eligible clinician’s and the range of the performance of all MIPS eligible clinician’s with respect to each performance category.

The proposed ruling will require that the Physician Compare site to include, to the extent practicable, processes to ensure that data made public is statistically valid, reliable, and accurate, including risk adjustment mechanisms used by the Secretary. All data must be statistically valid, accurate, reliable and all the data must prove through consumer testing to resonate with and be accurately interpreted by consumers in order to be included on Physician Compare profile pages. In addition, all measure data included on Physician Compare must be comparable.

Section 1848(q)(9)(C) of MACRA also requires that MIPS eligible clinicians be able to submit corrections for the information to be made public. There will be a 30-day preview period in advance of the publication of any data on Physician Compare. CMS will coordinate efforts between Physician Compare and the four components of MIPS in terms of data review and appeal and any relevant data re-submission or correction. All data available for public reporting — measure rates, scores, and/or attestations — will be available for review and correction during the targeted review process. The process will begin at least 30 days in advance of the publication of new data. Data under appeal and review will not be publicly reported until the review is complete. All corrected measure rates, scores, and/or attestations submitted will be available for public reporting.

Get ready for the Quality Payment Program today

Read our article on four ways to get ready for the Merit-Based Incentive Payment System (MIPS) introduced by MACRA