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 Medicare.gov compare tool and the Provider Data Catalog (PDC).

• What types of information are available for doctors, clinicians, and groups on the Medicare.gov compare tool profile pages and the Provider Data Catalog (PDC)?
• Do all Medicare doctors, clinicians, and groups have profile pages on the Medicare.gov compare tool?
• How is doctor, clinician, and group performance information displayed on Medicare.gov compare tool profile pages for doctors and clinicians?
• How is Alternative Payment Model (APM) participation and performance information publicly reported on the Medicare.gov compare tool profile pages and in the Provider Data Catalog (PDC)?
• Can doctors, clinicians, and groups preview their performance information before it’s publicly reported on the Medicare.gov compare tool profile pages and in the Provider Data Catalog (PDC)?

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

The Medicare.gov 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 Medicare.gov compare tool profile pages for doctors and clinicians includes:

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

Only doctors, clinicians, and groups who meet the following criteria will have profile pages on the Medicare.gov 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 Medicare.gov 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:

• Presentation: 2021 Quality Payment Program: Doctors and Clinicians Performance Information Published on Medicare Care Compare (Recording) (Slides (3.8 MB) (PDF)) (Transcript (147 KB) (PDF))
• 2021 Quality Payment Program Performance Information Published on Care Compare Fact Sheet (566 KB) (PDF)
• 2021 Clinician Performance Information (514 KB) (PDF)
• 2021 Group Performance Information (452 KB) (PDF)
• 2021 ACO Performance Information (224 KB) (PDF)
• 2021 Doctors and Clinicians Star Ratings Fact Sheet (726 KB) (PDF)
• 2021 Clinician and Group Star Rating Cut-offs (48.1 KB) (XLSX)
• 2021 Doctors and Clinicians Measures and Activities Plain Language Crosswalk (42 KB) (XLSX)

How is Alternative Payment Model (APM) participation and performance information publicly reported on the Medicare.gov 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:

• 2021 Quality Payment Program Performance Information Published on Care Compare Fact Sheet (566 KB) (PDF)
• 2021 ACO Performance Information (224 KB) (PDF)

Can doctors, clinicians, and groups preview their performance information before it’s publicly reported on the Medicare.gov 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 Medicare.gov 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.