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Physician Compare Overview

This overview provides information about the Physician Compare Website - Opens in a new window – its purpose, evolution and future.  

What is Physician Compare?

The Centers for Medicare and Medicaid Services (CMS) was required by Section 10331 of the Patient Protection and Affordable Care Act (ACA) of 2010 to establish the Physician Compare website. As a result, the site was launched on December 30, 2010. In its first iteration, Physician Compare utilized the existing Healthcare Provider Directory already part of Medicare.gov. Since that time, CMS has been working continually to enhance the site and its functionality, improve the information available, and include more and increasingly useful information about physicians and other healthcare professionals who take part in Medicare. This effort, along with the eventual addition of quality measures on the site, will help it serve its two-fold purpose

  • To provide information for consumers to encourage informed healthcare decisions; and
  • To create explicit incentives for physicians to maximize performance.

What information is available on Physician Compare?

Currently, Physician Compare is a website that allows consumers to search for physicians and other healthcare professionals who provide Medicare services. Some of the information on the site includes:

  • Physicians’ and other healthcare professionals’ names, addresses, phone numbers, specialties, clinical training, and genders.
  • If physicians and other healthcare professionals speak languages other than English.
  • The hospitals physicians and other healthcare professionals are affiliated with.
  • If physicians and other healthcare professionals accept the Medicare-approved amount (patient will not be billed for any more than the Medicare deductible and coinsurance).
  • Group practice information including their location addresses, phone numbers, maps and directions, specialties, as well as a list of physicians and other healthcare professionals within that practice.

How does CMS decide what to post on Physician Compare?

CMS uses feedback from the public and stakeholders through Town Hall meetings, Listening Sessions, e-mail received at PhysicianCompare@Westat.com, and the rulemaking process to define the scope and direction of Physician Compare. Through rulemaking, CMS proposes new policies, including what type of information will be publicly reported on Physician Compare in what years, and the public is provided the opportunity to comment on these proposals and give CMS their opinion.

What are the plans for public reporting of quality of care data on Physician Compare?

CMS has begun to implement a plan to make quality data available on Physician Compare. The Affordable Care Act (ACA) required the plan be established by January 1, 2013. The first step in this plan was outlined in the 2012 Physician Fee Schedule (PFS) Final Rule initiating a phased approach to public reporting. The second step as outlined in the 2013 PFS Final Rule furthers the plan to add quality data and other information to Physician Compare. According to this plan, CMS will post the first set of measure data on the site in calendar year 2014, reflecting data collected no sooner than program year 2012. These data will include Physician Quality Reporting System (PQRS) Group Practice Reporting Option (GPRO) measures for group practices and Accountable Care Organizations (ACOs).

The plan for Physician Compare also includes publically reporting patient experience data, such as the Clinician and Group Consumer Assessment of Healthcare Providers and Systems (CG CAHPS) measures, for ACOs and group practices of 100 or more eligible professionals participating in the 2013 PQRS GPRO as soon as technically feasible, but not before calendar year 2014.

How are CMS’ quality programs related to Physician Compare?

Physician Compare includes information about physicians and other healthcare professionals who satisfactorily participate in CMS quality programs.

The Physician Quality Reporting System (PQRS) is a pay-for-reporting program that gives eligible professionals incentives and payment adjustments if they report quality measures satisfactorily. Although PQRS is a standalone program, it touches on other CMS programs that require quality reporting, such as the eRx Incentive Program, the EHR Incentive Program, the Medicare Shared Savings Program, and the Value-based Payment Modifier. This Medicare program encourages physicians and other healthcare professionals to report information about the quality of the care they provide to people with Medicare who have certain medical conditions. Physicians and other healthcare professionals can choose whether to report quality information through PQRS. Profile pages show whether physicians and other healthcare professionals have taken part in PQRS.

The Electronic Prescribing (eRx) Incentive Program is a pay-for-reporting program that encourages physicians and other healthcare professionals to use electronic prescribing to improve communication, increase accuracy, and reduce errors. To participate in this Medicare program, physicians and other healthcare professionals must report on their use of a qualified eRx system. Profile pages show if physicians and other healthcare professionals are participating in the eRx Incentive Program.

The Electronic Health Record (EHR) Incentive Program is a Medicare program that provides incentives and payment adjustments to eligible professionals who use certified EHR technology in ways that may improve healthcare. Profile pages will show if physicians and other healthcare professionals are participating in the EHR Incentive Program.

E-mail feedback and questions to the Physician Compare team at PhysicianCompare@Westat.com.