Performance Information and Physician Compare

This section provides more information about quality measures data and the public reporting plan for Physician Compare. To learn more about Physician Compare’s Statutory Authority, visit the section About Physician Compare: An Overview. Select the question below to view the corresponding answer.

General Quality Data Information

How does CMS decide what to post on Physician Compare?
What performance information is available on Physician Compare?
Will all individual and group measures designated as “available for public reporting” be included on Physician Compare?
How are measures determined to be “available for public reporting”?
How are measures displayed on Physician Compare?
If an individual clinician participates in a group, will the clinician have measure data on his/her profile page?
Can users compare individual clinicians or groups on Physician Compare?

Quality Measures Data

Are ACO performance information available on Physician Compare?
What performance information was added to Physician Compare profile pages in early 2019?
How is Alternative Payment Model (APM) information included on Physician Compare?

Quality Payment Program and Physician Compare

What is the Quality Payment Program and how does it relate to Physician Compare?

30-Day Preview Period

How do individual clinicians and groups preview their performance information before it is posted on Physician Compare?

General Quality Data Information

How does CMS decide what to post on Physician Compare? 

As part of CMS’s continued phased approach to public reporting on Physician Compare, CMS is publicly reporting a subset of the 2017 Quality Payment Program (Year 1) performance information submitted under the Merit-based Incentive Payment System (MIPS) and Alternative Payment Models (APMs). The specific measures included on the website are chosen based on statistical and user testing. 

Performance information on the Physician Compare website is publicly reported on clinician and group profile pages and in the Physician Compare Downloadable Database. All performance information on Physician Compare must meet the established public reporting standards (§414.1395(b)). To be included in the Physician Compare Downloadable Database, which is intended for clinicians, groups, and third-party data users, performance information must be statistically valid, reliable, and accurate; be comparable across collection types; and meet the minimum reliability threshold, as determined by statistical testing.

The primary audience for Physician Compare profile pages is Medicare patients and their caregivers. To be included on Physician Compare public-facing profile pages, performance information must meet the public reporting standards and also resonate with Medicare patients and caregivers, as determined by user testing. We are continuing to evaluate options for expanding the types of measures that are publicly reported on Physician Compare. 

Additionally, the following measure types will not be publicly reported on Physician Compare at this time: quality and cost measures that are in the first two years of use, first year improvement activities, and first year advancing care information objectives and measures. 

[Back to top]

What performance information is available on Physician Compare?

Physician Compare includes information about clinicians and groups who participate in CMS quality programs. More information about each type of indicator is available below.

Participation Indicators

Innovative model participation

Alternative Payment Models (APMs) aim to improve the quality and cost-efficiency of care for patients and populations. APMs can apply to aspects of care such as a specific condition, a care episode, or a population. If a clinician or group participates in one or more Alternative Payment Models with Medicare, Physician Compare displays the name of model(s) and a green check mark on their profile page with the following text: 

This clinician or group participates in an Alternative Payment Model (APM) with Medicare that aims to improve care delivery for patients.

While participation in an Alternative Payment Model with Medicare shows a commitment to quality care, it does not directly affect the way that patients pay the clinician or group. 

Electronic Health Record Technology participation

The Electronic Health Record Technology performance category promotes the secure electronic exchange of information using certified electronic health record technology that encourages patient engagement and communication between clinicians. If a clinician or group was a successful performer in the Electronic Health Record Technology performance category in 2017, Physician Compare displays a green check mark on their profile page with the following text: 

This clinician or group is a successful performer in the Electronic Health Record Technology performance category.

The Electronic Health Record Technology performance category is one of four performance categories of a Medicare initiative that provides clinicians with new tools and resources to help them give patients the best possible care.

Healthcare Performance

Physician Compare has performance information that shows how well clinicians and groups provide patients with the best recommended care. Star ratings for groups show how well the group provided the recommended care to patients compared to the best performers for each measure. This performance information comes from the Merit-based Incentive Payment System (MIPS). We are publicly reporting a subset of group MIPS measures as star ratings on Physician Compare group profile pages. The measures are divided into these categories:

  • Preventive care: General health
  • Preventive care: Cancer screening
  • Patient safety
  • Care planning
  • Diabetes
  • Heart disease
  • Respiratory diseases
  • Behavioral health

Additional performance information may be available for clinicians and groups who reported information to Medicare through a qualified clinical data registry (QCDR). A QCDR is a Medicare partner organization that is committed to improving the quality of patient care. QCDRs can improve the quality of patient care by developing quality measures and collecting and reporting performance information.

At this time, not all clinicians and groups have performance information on their Physician Compare profile page. If a clinician or group doesn’t have performance information available, they can still be committed to giving high quality care. Only some of the information reported to Medicare is currently available on Physician Compare profile pages. It is also important to understand that:

  • Not all clinicians and groups report the same information to Medicare, because not all clinicians provide the same services to patients. Also, not all services or types of care have measures available to report to Medicare.
  • Reporting more or less information is not a reflection of quality.
  • The available performance information is not a complete picture of the types of services clinicians and groups provide. It is just a snapshot of some of the care clinicians and groups give to Medicare patients.

Patient survey scores

Patient survey scores come from the Consumer Assessment of Healthcare Providers and Systems (CAHPS) for MIPS Survey, which is specifically for groups caring for Medicare patients. The survey asks patients about their experiences with clinicians in the groups they visit for care. It covers important topics, like how well your clinician communicates.

You can use this information to learn about other patients’ experiences with the group and to make more informed healthcare decisions. Groups that participate in this survey get performance scores based on the information their patients reported about them. Some groups have these performance scores on their Physician Compare profile page. Some groups are committed to providing high quality care but do not have patient survey scores. 

[Back to top]

Will all individual and group measures designated as “available for public reporting” be included on Physician Compare?

If a group or individual clinician reports any of the measures designated as “available for public reporting”, then the measure may be included on the Physician Compare website. However, only those measures deemed to meet the public reporting standards are considered for inclusion on the website. 

All data on Physician Compare must meet our established public reporting standards. They must be statistically valid, reliable, and accurate; comparable across collection types; and meet the minimum reliability threshold to be included in the Physician Compare Downloadable Database. To be included on Physician Compare public-facing profile pages, data must resonate with website users, as determined by user testing.

How are measures determined to be “available for public reporting”?

Measures deemed as “available for public reporting” are determined by law and rulemaking. The Physician Compare support team conducts user testing to determine which measures to include on the public-facing profile pages that are the most meaningful for patients and caregivers. This user testing includes

  • Having users evaluate the plain language measure descriptions to ensure that they are accurately interpreted; and
  • Discussing with users how and if the measures they are evaluating would help them make a decision about choosing an individual clinician or group. 

All other measures available for public reporting are included in the Downloadable Database, a resource intended for intended for clinicians, groups, and third-party data users. CMS keeps open lines of communication with stakeholders to ensure that measures considered for public reporting are clinically relevant and consistent with current practice standards. 

[Back to top]

How are measures displayed on Physician Compare? 

Each measure displayed on a profile page includes a measure title, performance score, and measure description. The measure title and the associated performance score - displayed as a 5-star rating or percentage - are automatically displayed on the profile page. To view the detailed measure description, a user can then expand each measure to see additional information.

At this time, a subset of 2016 performance period group-level PQRS measures are displayed as star ratings. For groups, CAHPS for PQRS measures are reported as top-box scores. Top-box scores show the percentage of responses in the most positive response categories to ensure correct interpretation of patient experience data. For both groups and clinicians, we report QCDR measures that meet our public reporting standards as percent performance rates.  

[Back to top]

If an individual clinician participates in a group, will the clinician have measure data on his/her profile page?

Group measures are only displayed on the group profile page. Individual clinicians who participate in a group will not have individual clinician data for display on their profile page. Individual clinician data will only be displayed at the individual level. If an individual clinician is affiliated with a group that has measure data, under the General Information tab, there is a link from the clinician’s page to their group’s page. Next to the group affiliation link, there is a star icon that indicates there is performance information available on the group’s page.

[Back to top]

Can users compare individual clinicians or groups on Physician Compare?

Users can compare individual clinicians to other individual clinicians and groups to other groups on Physician Compare. You can select up to three groups or three clinicians to compare side-by-side. 

[Back to top]

Quality Measures Data

Are ACO performance information available on Physician Compare?

Users can access these data from the Physician Compare home page by clicking on the “Accountable Care Organization (ACO) performance scores” link in the Resources for Professionals section. From there, users can search for an ACO to view the ACO’s performance information. This will take them to a section of the website dedicated solely to Shared Savings Program, Pioneer, and Next Generation ACO public reporting. At the top of the page there is general information about the ACO program, a link to the ACO website, and the 2017 performance information available. Users can search for an ACO in two ways. The “Search for an ACO” link under Resources for professionals allows users to search for an ACO by name or browse through all ACOs with the “Search A-Z Index” option.

[Back to top]

What performance information was added to Physician Compare profile pages in 2019?

The 2017 Quality Payment Program performance information available for public reporting on public-facing profile pages in 2019 include:

  • 12 MIPS quality measures reported by groups and displayed as measure-level star ratings on group profile pages
  • 8 Consumer Assessment for Healthcare Provider and Systems (CAHPS) for MIPS summary survey measures displayed as top-box percent performance scores on group profile pages. 
  • 6 Qualified Clinical Data Registry (QCDR) quality measures reported by groups and displayed as percent performance scores on group profile pages
  • 11 QCDR quality measures reported by individual clinicians and displayed as percent performance scores on individual clinician profile pages

For more information about the specific performance information selected for public reporting on clinician and group profile pages, download the following documents:

[Back to top]

How is Alternative Payment Model (APM) information included on Physician Compare?

Physician Compare is publicly reporting information about 2017 APM participation in the following ways:

For more information about the specific performance information selected for public reporting on ACO profile pages, download Accountable Care Organization (ACO) Performance Information on Physician Compare: Performance Year 2017 (PDF)

[Back to top]

Quality Payment Program and Physician Compare

What is the Quality Payment Program and how does it relate to Physician Compare?

Learn about how Quality Payment Program performance information is selected for public reporting on Physician Compare in the Quality Payment Program and Physician Compare Factsheet: What You Need to Know for Performance Year 2017 (PDF)

[Back to top]

30-Day Preview Period

How do individual clinicians and groups preview their performance information before it is posted on Physician Compare? 

All groups and individual clinicians with measure data will have a 30-day preview period prior to publication of their data. This allows groups and individuals to see their data as it will appear on Physician Compare before it is reported.

The preview period will be announced via the Physician Compare GovDelivery listserv and other CMS outreach avenues such as the Physician Compare Initiative Page, and MLN Connects listserv. Therefore, it is important that everyone keep an eye out for information that preview period has started. 

If you have any questions about measure preview or public reporting generally, you can always direct those questions to the Physician Compare support team.

You are welcome to send feedback and questions to the Physician Compare support team at PhysicianCompare-Helpdesk@AcumenLLC.com.

[Back to top]

Page Last Modified:
12/04/2019 03:15 PM