Publicly Reported General and Performance Information

Publicly Reported General and Performance Information

This section provides an overview of the publicly reported general and performance information for doctors and clinicians on the compare tool and the Provider Data Catalog (PDC).

What types of information are available for doctors, clinicians, and groups on the compare tool profile pages and the Provider Data Catalog (PDC)? 

The compare tool and the Provider Data Catalog (PDC) include Quality Payment Program (QPP) performance information and other general information for Medicare doctors, clinicians, and groups.

Some of the general information on the compare tool profile pages for doctors and clinicians includes:

General Information
InformationDoctors and CliniciansGroups
Addresses and phone numbers
Medical specialties
Medicare assignment status
Board certifications 
Group affiliation 
Hospital affiliation 
Facility affiliation 
Affiliated clinicians 
Alternative Payment Model (APM) affiliation 
Accountable Care Organization (ACO) affiliation 
Telehealth services 
Utilization (procedure volume) data 

Do all Medicare doctors, clinicians, and groups have profile pages on the compare tool?

Only doctors, clinicians, and groups who meet the following criteria will have profile pages on the compare tool:

  • Be in approved status in the Provider Enrollment, Chain, and Ownership System (PECOS);
  • Have at least one practice location address in PECOS;
  • Have at least one specialty in PECOS;
  • Have submitted an Original Medicare claim or be newly enrolled in PECOS within the last 6 months; and
  • Groups must also have a legal business name and at least 2 active Medicare clinicians reassigning their benefits to the group’s Tax Identification Number (TIN).

How is doctor, clinician, and group performance information displayed on compare tool profile pages for doctors and clinicians?

Performance information for doctors, clinicians, and groups (if available) is displayed using measure-level star ratings, percent performance scores, and checkmarks. Refer to the below files for specific information about how this performance information is publicly reported:

How is Alternative Payment Model (APM) participation and performance information publicly reported on the compare tool profile pages and in the Provider Data Catalog (PDC)?

Information about 2021 APM participation is reported in the following ways:

  • Measure-level performance scores for groups participating in Medicare Shared Savings Program ACOs are displayed on the group profile page through a pop-up modal for a subset of their quality measures submitted via the APM Performance Pathway (APP).
  • Groups that participated in Shared Savings Program ACOs have an indicator of APM participation on their group profile page.
  • Clinicians and groups have an indicator of APM participation on their profile pages if they participated in the selected APMs.
  • Clinicians who participated in an APM and submitted performance information as individual clinicians in 2021 may or may not have individual performance information available on their profile pages.

For more information about APMs and public reporting, download the following documents:

Can doctors, clinicians, and groups preview their performance information before it’s publicly reported on the compare tool profile pages and in the Provider Data Catalog (PDC)? 

All doctors, clinicians, and groups with performance information targeted for public reporting on the compare tool profile pages and the PDC will be able to preview their data before it’s published. The Doctors and Clinicians Preview Period is an opportunity for doctors, clinicians, and groups to see their performance information before it’s publicly reported. The Doctors and Clinicians Preview Period will be announced via the Care Compare: Doctors and Clinicians listserv and other interested party listservs, as well as the Care Compare: Doctors and Clinicians Initiative page.

Accountable Care Organizations (ACOs) are able to review their annual performance information via their Medicare Shared Savings Program Quality Performance Reports and MIPS Performance Feedback.

Page Last Modified:
03/11/2024 04:25 PM