Care Compare: Doctors and Clinicians Initiative

Care Compare: Doctors and Clinicians Initiative

The Centers for Medicare & Medicaid Services (CMS) publicly reports Quality Payment Program (QPP) performance information, if available, for doctors, clinicians, groups, and Accountable Care Organizations (ACOs) on the doctors and clinicians sections of the Medicare.gov compare tool profile pages and the Provider Data Catalog (PDC).

Spotlight and Announcements

Doctor and Clinician Utilization (Procedure Volume) Data Now Available on Medicare.gov Compare Tool

The Centers for Medicare & Medicaid Services (CMS) added utilization data, specifically procedure volume, for the first time on the Medicare.gov compare tool’s profile pages for doctors and clinicians. The procedures initially added to profile pages were performed by doctors and clinicians for Original Medicare and Medicare Advantage patients in the last 12 months, after allowing a three-month claim processing period (for example, claims for dates of service occurring between June 1, 2022 through June 30, 2023 that were processed by September 30, 2023) 

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Utilization data was first published only in a downloadable format in late 2017. This information is a subset of the “Medicare Physician & Other Practitioners – by Provider and Service” dataset, and is currently published in the Provider Data Catalog (PDC). A procedure volume data file is now available and includes the procedure category information currently publicly reported on the compare tool on Medicare.gov profile pages for doctors and clinicians.

The initial release of procedure volume data on doctor and clinician profile pages includes 12 procedures (additional procedures will be added periodically, as feasible):

  1. Hip replacement
  2. Knee replacement
  3. Spinal fusion
  4. Cataract surgery
  5. Colonoscopy
  6. Hernia repair – groin (open)
  7. Hernia repair (minimally invasive)
  8. Mastectomy
  9. Coronary artery bypass graft (CABG)
  10. Pacemaker insertion or repair
  11. Coronary angioplasty and stenting
  12. Prostate resection 

For more information, access the “Utilization (Procedure Volume) Data Published on the Compare Tool on Medicare.gov” fact sheet (PDF, 195 KB).

Address Suppression Available for Clinicians Providing Telehealth or Other Non-Patient-Facing Services From Their Homes

Doctors and clinicians who provide telehealth-only or other non-patient-facing services in their homes can suppress their street addresses on Medicare.gov compare tool profile pages.

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A doctor or clinician may need to enroll their home address as a practice location but prefer their personal contact information not be publicly reported. Doctors and clinicians can either mark the address as a “Home office for administrative/telehealth use only” location in the Provider Enrollment, Chain, and Ownership System (PECOS), which will suppress street address details, or email the QPP Service Center to suppress the street address and/or phone number. In such cases, CMS maintains city, state, and zip code information so that doctors and clinicians can still be included in searches and have their performance information reported.

CMS may also suppress street addresses when there’s a safety concern related to a clinician’s practice location information being publicly available.

For more information, please visit the “About the Data” and “Frequently Asked Questions” sections of the Care Compare: Doctors and Clinicians Initiative page.

2021 Quality Payment Program (QPP) Performance Information Now Available on the Medicare.gov Compare Tool

The Centers for Medicare & Medicaid Services (CMS) added new 2021 Quality Payment Program (QPP) performance information, if available, for doctors, clinicians, groups, virtual groups, and Accountable Care Organizations (ACOs) on Medicare.gov compare tool profile pages for doctors and clinicians and the Provider Data Catalog (PDC). Section 1848(q)(9)(A) and (D) of MACRA requires CMS to publicly report MIPS eligible clinicians’ final scores and performance under each MIPS performance category, the names of eligible clinicians in Advanced Alternative Payment Models (APMs) and, to the extent feasible, the names and performance of those Advanced APMs. Performance information for doctors and clinicians is displayed using measure-level star ratings, percent performance scores, and checkmarks.

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Medicare patients and caregivers can use the compare tool on Medicare.gov to search for doctors, clinicians, and groups practicing under Medicare. Publicly reporting 2021 QPP performance information helps improve access to care by providing information to patients and caregivers on Medicare.gov compare tool profile pages for doctors and clinicians.

Refer to the documents below for more details about the 2021 QPP performance information that has been added to Medicare.gov profile pages for doctors and clinicians and the PDC: 

Now Available: Telehealth Indicator for Doctors and Clinicians on Care Compare

The Centers for Medicare & Medicaid Services (CMS) added a new telehealth indicator on profile pages for doctors and clinicians on the Medicare.gov compare tool and the Provider Data Catalog (PDC). The indicator may help beneficiaries and caregivers more easily find clinicians who provide telehealth services. 

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Telemedicine services expanded in response to the COVID-19 public health emergency to improve patients’ access to care. The telehealth indicator is the latest example of CMS’ efforts to ensure the compare tool on Medicare.gov provides patients and caregivers with information about services they may value as they search for clinicians.

For more information, access the “Telehealth Indicator on Medicare Care Compare: Doctors and Clinicians Public Reporting” fact sheet (PDF, 583 KB).

Medicare.gov Compare Tool Update: Additional Doctor and Clinician Facility Affiliation Information Now Included

The Centers for Medicare & Medicaid Services (CMS) updated doctor and clinician profile pages on the Medicare.gov compare tool to include facility affiliation information for the following facility types, as applicable (in addition to the hospital affiliations previously available):

  • Long-term Care Hospitals (LTCHs)
  • Skilled Nursing Facilities (SNFs)
  • Inpatient Rehabilitation Facility (IRFs)
  • Home Health Agencies
  • Hospices
  • Dialysis Facilities
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This update, which includes links from doctor and clinician profile pages to specify facility profile pages, may help patients and caregivers since it:

  • Provides additional information to support patients and caregivers as they make health care decisions.
  • Offers information about clinicians who aren’t affiliated with a hospital but work in other types of health care facilities.
  • Creates additional quality information linkages between clinicians and facilities across the compare tool on Medicare.gov pages.

Visit doctor and clinician profile pages on Medicare.gov to access this update. The facility affiliations are displayed in a dedicated “Affiliations” section for easy access. Doctor and clinician group membership will continue to be listed separately in the “Details” section as a fundamental part of a clinician’s profile.

Medicare.gov Compare Tool Update: Expanded Archive for Doctors and Clinicians - Now Available

The Centers for Medicare & Medicaid Services (CMS) has expanded the archive for doctors and clinicians in the Provider Data Catalog (PDC) on Medicare.gov. This expansion allows users to access historical Merit-based Incentive Payment System (MIPS) program performance data that were previously publicly reported since the program’s inception in 2017.

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Prior to this archive expansion, CMS publicly reported one year of MIPS performance data at a time. This update benefits doctors, clinicians, researchers, and other interested parties who want access to historical MIPS performance data previously publicly reported. 

The addition of historical information to CMS’ publicly reported information supports overall data transparency and aligns the types of information reported for all provider settings. Users can access the archive files (ZIP).

Caution

CMS strongly cautions users against using the historical data to draw year-to-year performance comparisons. There are several aspects of the MIPS program and public reporting standards that make it inappropriate to make such comparisons – especially of measure-level performance over time. Additional details and information are available in the "MIPS Data Archive on Care Compare: Doctors and Clinicians" fact sheet and disclaimer (135 KB) (PDF).

2023 CMS Health Equity Conference Poster

The Doctors and Clinicians team presented a poster, “Helping Increase Access to Care: The Doctors and Clinicians Profile Pages on the Medicare.Gov Compare Tool (404 KB) (PDF)” at the inaugural CMS Health Equity Conference held June 7-8, 2023. The poster describes how doctor and clinician profile pages advance health equity by supporting access to care and ensuring that the information on the Medicare.gov compare tool is accessible to all. 

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The poster summarizes how patients and caregivers can search for doctors and clinicians and review practice and performance information (if available). Information about payment amounts and the availability of telehealth may help all users access care, and it may be especially valuable to populations facing financial barriers, residing in medically underserved areas or managing disability. The poster also describes CMS’ robust, health equity-informed approach, including the use of plain language, user testing, support for users without internet access, and maintaining a separate Spanish-language site, which helps ensure that information on the profile pages is accessible to diverse users.

2023 Quality CMS Quality Conference Poster

During the 2023 CMS Quality Conference held May 1-3, the Doctors and Clinicians team presented a poster, “CMS Continues Phased Approach to Public Reporting Doctor and Clinician Information (452 KB) (PDF)." The poster provides background about the information reported on the Medicare.gov compare tool profile pages for doctors and clinicians and the Provider Data Catalog (PDC), and key public reporting milestones covering the 2019 through 2021 performance years. The poster also features details about the new telehealth indicator, which may be particularly useful for people with limited health care access, and those unable to physically travel to a doctor or clinician's office. 

Contact Us

If you have any questions about public reporting for doctors and clinicians on the Medicare.gov compare tool, contact the Quality Payment Program (QPP) Service Center by email at QPP@cms.hhs.gov, by creating a QPP Service Center ticket, or by phone at 1-866-288-8292 (Monday-Friday, 8 a.m. - 8 p.m. ET).

To receive assistance more quickly, especially during busier periods such as the submission window, please consider calling during non-peak hours — before 10 a.m. and after 2 p.m. ET.

People who are deaf or hard of hearing can dial 711 to be connected to a Telecommunications Relay Services (TRS) Communications Assistant. 

To receive updates, subscribe to the QPP and Care Compare: Doctors and Clinicians listservs.

Page Last Modified:
03/01/2024 12:37 PM