Spotlight and Announcements
Spotlight and Announcements
2024 AcademyHealth Annual Research Meeting Posters
The Doctors and Clinicians (DAC) team presented the following informational posters at the AcademyHealth Annual Research Meeting held June 29-July 2, 2024:
- Clinician Participation in Fee-For-Service Medicare, Quality Measure Performance Reporting, and the Practices Through Which They Participate During the COVID-19 Public Health Emergency (3.24 MB) (PDF): Reports key study findings about trends related to Medicare participation, clinician population changes by state, and Merit-based Incentive Payment System (MIPS) performance public reporting during the public health emergency. The team studied clinicians and groups as listed on the Medicare.gov compare tool and in the Provider Data Catalog.
- Medicare.gov Compare Tool | Assessing the Usefulness of Clinician Procedure Data to Consumers for Informed Decision Making (358.72 KB) (PDF): Following human-centered design principles, one-on-one virtual interviews were conducted with Medicare beneficiaries and their caregivers to assess the usefulness of publicly reporting procedure information on the Medicare.gov compare tool when choosing a clinician. CMS released a display of procedure information for an initial subset of 12 commonly performed procedures to help consumers identify a clinician with experience in providing the care they need.
Additional Procedures Data Now Available on Medicare.gov Compare Tool
As part of the Centers for Medicare & Medicaid Services’ (CMS) ongoing effort to inform patients and caregivers about clinicians’ experiences, CMS has added new procedures to the utilization data on the Medicare.gov compare tool’s profile pages for doctors and clinicians.
- Learn more
In January 2024, CMS added the first procedure volume data file with information for 12 procedures publicly reported on Medicare.gov compare tool profile pages for doctors and clinicians:
- Hip replacement
- Knee replacement
- Spinal fusion
- Cataract surgery
- Colonoscopy
- Hernia repair – groin (open)
- Hernia repair (minimally invasive)
- Mastectomy
- Coronary artery bypass graft (CABG)
- Pacemaker insertion or repair
- Coronary angioplasty and stenting
- Prostate resection
The July 2024 release expands the list of procedures to include:
- Upper endoscopy
- Arthroscopy – upper extremity
- Arthroscopy – lower extremity
- Varicose vein ablation
- Laminectomy/laminotomy (lumbar)
- Lower limb revascularization
The procedures added to profile pages were performed by doctors and clinicians for Original Medicare and Medicare Advantage patients in the previous 12 months, after allowing a three-month claim processing period (for example, claims for dates of service occurring between January 1, 2023, and December 31, 2023, that were processed by April 1, 2024). CMS will continue to add more procedures to Medicare.gov compare tool profile pages periodically, as feasible.
The “Utilization (Procedure Volume) Data Published on the Compare Tool on Medicare.gov July 2024 (PDF)” fact sheet (PDF, 386.64 KB) provides the full list of procedures and background information about CMS’ reporting of procedure volume data. The current procedure volume data file is available as part of the doctors and clinicians datasets.
2022 Quality Payment Program (QPP) Performance Information Now Available on the Medicare.gov Compare Tool
The Centers for Medicare & Medicaid Services (CMS) added new 2022 Quality Payment Program (QPP) performance information for doctors, clinicians, groups, virtual groups, and Accountable Care Organizations (ACOs) to clinician and group profile pages on the Medicare.gov compare tool and in the Provider Data Catalog (PDC). CMS is required to report MIPS eligible clinicians’ final scores and performances under each MIPS performance category, names of eligible clinicians in Advanced Alternative Payment Models (APMs) and, to the extent feasible, the names and performance of such Advanced APMs. Performance information for doctors and clinicians is displayed using measure-level star ratings, percent performance scores, and checkmarks.
Medicare patients and caregivers can use the compare tool on Medicare.gov to search for and compare doctors, clinicians, and groups who are enrolled in Medicare. Publicly reporting 2022 QPP performance information helps empower patients to select and access the right care from the right provider.
Refer to the documents below for more details about the 2022 QPP performance information that has been added to clinician and group profile pages on the Medicare.gov compare tool and in the PDC:
- Presentation: 2022 Quality Payment Program: Doctors and Clinicians Performance Information Published on the Medicare.gov Compare Tool (Recording) (Slides (610.62 KB) (PDF)) (Transcript (157.9 KB) (PDF))
- 2022 Quality Payment Program Performance Information Published on the Medicare.gov Compare Tool Fact Sheet (222.73 KB) (PDF)
- 2022 Clinician Performance Information (363.68 KB) (PDF)
- 2022 Group Performance Information (394.57 KB) (PDF)
- 2022 ACO Performance Information (141.6 KB) (PDF)
- 2022 Doctors and Clinicians Star Ratings Fact Sheet (322.01 KB) (PDF)
- 2022 Clinician and Group Star Rating Cut-offs (49.74 KB) (XLSX)
- 2022 Doctors and Clinicians Measures and Activities Plain Language Crosswalk (41.7 KB) (XLSX)
2024 CMS Quality Conference Posters
During the 2024 CMS Quality Conference held April 8-10, the Doctors and Clinicians team presented the following informational posters:
- Compare Tool: Procedure Volume, Facility Affiliation, MIPS Performance, and APM Participation (705.72 KB) (PDF): Provides background about the information reported on profile pages for doctors and clinicians on the Medicare.gov compare tool and in the Provider Data Catalog (PDC), including publicly reported clinician- and group-level MIPS measures and attestations during the 2020 through 2022 performance years.
- Implementing Procedure Volume Reporting on Medicare.gov Compare Tool (1.49 MB) (PDF): Details the process CMS uses to report doctor and clinician scope and experience information patients and caregivers can consider when seeking care. CMS published procedure volume data on profile pages for doctors and clinicians on the Medicare.gov compare tool for the first time in January 2024.
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.
- Learn more
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.
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.
- Learn more
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
- Learn more
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.
- Learn more
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.
- Learn more
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.
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:
09/10/2024 06:23 PM