physician compare 2016 public reporting...
TRANSCRIPT
Physician Compare
Public Reporting Webinar February 2016
Alesia Hovatter Health Policy Analyst
Division of Electronic and Clinician Quality Quality Measurement and Value-Based Incentives Group
Center for Clinical Standards and Quality Centers for Medicare & Medicaid Services
Disclaimers
This presentation was current at the time it was published or uploaded onto the web. Medicare policy changes frequently so links to the source documents have been provided within the document for your reference.
This presentation was prepared as a tool to assist providers and is not intended to grant rights or impose obligations. Although every reasonable effort has been made to assure the accuracy of the information within these pages, the ultimate responsibility for the correct submission of claims and response to any remittance advice lies with the provider of services. The Centers for Medicare & Medicaid Services (CMS) employees, agents, and staff make no representation, warranty, or guarantee that this compilation of Medicare information is error-free and will bear no responsibility or liability for the results or consequences of the use of this guide. This publication is a general summary that explains certain aspects of the Medicare Program, but is not a legal document. The official Medicare Program provisions are contained in the relevant laws, regulations, and rulings.
CPT only copyright 2011 American Medical Association. All rights reserved. CPT is a registered trademark of the American Medical Association. Applicable FARS\DFARS Restrictions Apply to Government Use. Fee schedules, relative value units, conversion factors and/or related components are not assigned by the AMA, are not part of CPT, and the AMA is not recommending their use. The AMA does not directly or indirectly practice medicine or dispense medical services. The AMA assumes no liability for data contained or not contained herein.
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Welcome
• Purpose of the Session – Recent updates to the Physician Compare website. – Future plans for public reporting on Physician
Compare.
• Q&A
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Overview
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Public Reporting by Year
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Physician Compare
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Public Reporting Standards
• Any measure designated in the PFS Rule as “available for public reporting” may be included on the Physician Compare website.
• Publicly reported measures must be statistically accurate, comparable, valid, and reliable and resonate with consumers.
• Consumer testing is used to evaluate the best
measures to include on the public-facing profile pages.
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Physician Compare: Next Steps
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Why does Physician Compare need a benchmark?
• A benchmark helps consumers understand quality data on Physician Compare by providing: – Context for measures performance rates; and – A point of comparison.
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Benchmark Background
• Physician Compare conducted a fact-finding process.
• An item (or measure)-level benchmark derived using the Achievable Benchmark of Care or “ABC™” methodology was finalized in the 2016 Physician Fee Schedule final rule.
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Benefits of the ABC™ Methodology
• The ABC™ methodology is: – Well-tested, data-driven methodology; – Establishes top performers; and – Provides a point of comparison.
• The benchmark represents quality while being both realistic and achievable.
• The benchmark is based on the currently available data.
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Benchmark Methodology
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Example Benchmark Methodology
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Example Benchmark Methodology
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Example Benchmark Methodology
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Example Benchmark Methodology
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Example Benchmark Methodology
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Benchmark Next Steps
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• The benchmark is specific to the measure and reporting mechanism.
• The earliest the benchmark will be publicly reported is late 2017.
• CMS is currently analyzing how 5-star ratings will be derived from the benchmark.
Question & Answer
• Q&A session – Raise your hand – Type a question
• Questions?
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For More Information
• Please direct inquiries regarding Physician Compare to [email protected]
• Find additional information at CMS.gov – Search for “Physician Compare”
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