Enhancements to Procedure Data on Care Compare
CMS is committed to enhancing transparency in healthcare, and a significant part of this commitment is expanding the data available on the Care Compare tool. Recently, CMS added new procedures to the utilization data showcased on doctor and clinician profile pages within Care Compare. This expansion provides patients with a more detailed view of clinicians’ experience across a broader range of medical procedures.
Initially, in January 2024, CMS introduced procedure volume data for 12 key procedures. This initial set included common and critical procedures such as hip and knee replacements, spinal fusion, cataract surgery, colonoscopy, and various hernia repairs, among others. This data allowed users to see the volume of these procedures performed by individual doctors and clinicians.
Building upon this foundation, the July 2024 update significantly broadened the scope by adding six more procedures. The expanded list now includes upper endoscopy, arthroscopy for both upper and lower extremities, varicose vein ablation, lumbar laminectomy/laminotomy, and lower limb revascularization. This richer dataset offers a more complete picture of the services offered and the experience of healthcare providers listed on Care Compare.
These procedure volumes represent services performed for both Original Medicare and Medicare Advantage patients within the preceding 12 months, ensuring the data is current and relevant. CMS continues to refine and expand Care Compare, with plans to incorporate even more procedures in the future, further solidifying its position as a comprehensive resource for healthcare information.
2022 Quality Payment Program (QPP) Performance Information Now Available
Transparency in healthcare extends beyond procedure volumes to encompass performance and quality metrics. The Care Compare tool now includes 2022 Quality Payment Program (QPP) performance information, offering valuable insights into the quality of care provided by doctors, clinicians, groups, virtual groups, and Accountable Care Organizations (ACOs).
This QPP data is presented in an accessible format, utilizing measure-level star ratings, percentage performance scores, and checkmarks. This visual representation allows Medicare beneficiaries and their caregivers to easily assess and compare the performance of different providers. CMS is mandated to report final scores and performance under the Merit-based Incentive Payment System (MIPS), as well as identify clinicians participating in Advanced Alternative Payment Models (APMs). By making this information public, Care Compare empowers patients to make well-informed decisions and choose providers who best meet their healthcare needs.
Address Suppression for Telehealth and Non-Patient-Facing Services
Recognizing the evolving landscape of healthcare delivery, CMS has implemented features to accommodate telehealth and non-patient-facing services within Care Compare. Doctors and clinicians who primarily offer telehealth or administrative services from their homes can now suppress their street addresses on their Care Compare profiles.
This feature addresses privacy concerns for clinicians who use their home address as a practice location for these specific types of services. Clinicians can designate their address as a “Home office for administrative/telehealth use only” in the Provider Enrollment, Chain, and Ownership System (PECOS). Alternatively, they can contact the QPP Service Center to request address and/or phone number suppression. Importantly, even with street address suppression, city, state, and zip code information remains visible, ensuring these clinicians are still discoverable in searches and their performance data is reported. This thoughtful approach balances transparency with the privacy needs of healthcare providers in the modern era of telehealth.
Telehealth Indicator Enhances Searchability on Care Compare
To further facilitate access to telehealth services, CMS has added a dedicated telehealth indicator to doctor and clinician profiles on Care Compare. This indicator clearly highlights providers who offer telehealth services, making it easier for beneficiaries and caregivers to find clinicians who provide remote care options.
The telehealth indicator reflects the increased importance of telemedicine in healthcare, particularly following the expansion of telehealth services during the COVID-19 public health emergency. This feature exemplifies CMS’s ongoing efforts to ensure Care Compare remains a user-friendly and relevant tool, providing patients with the information they value most when seeking healthcare providers.
Expanded Facility Affiliation Information for Comprehensive Care Insights
Understanding the affiliations of doctors and clinicians can provide valuable context for patients seeking care. Care Compare now offers expanded facility affiliation information, going beyond hospital affiliations to include a wider range of healthcare settings.
In addition to hospitals, Care Compare now displays affiliations with Long-Term Care Hospitals (LTCHs), Skilled Nursing Facilities (SNFs), Inpatient Rehabilitation Facilities (IRFs), Home Health Agencies, Hospices, and Dialysis Facilities. These affiliations are conveniently located in a dedicated “Affiliations” section on doctor and clinician profiles, with links to the respective facility profile pages. This enhancement provides a more holistic view of a clinician’s practice and enables patients to understand the network of facilities associated with their care. This is particularly helpful for patients requiring specialized or post-acute care, as it allows them to see the connections between different providers and facilities within the healthcare ecosystem.
Historical Performance Data Archive for In-Depth Analysis
For researchers, clinicians, and anyone interested in long-term performance trends, Care Compare now offers an expanded archive of historical Merit-based Incentive Payment System (MIPS) program performance data. This archive extends back to the program’s inception in 2017, providing a longitudinal view of performance data that was previously publicly reported.
Previously, only one year of MIPS performance data was publicly accessible at a time. This archive expansion provides access to a wealth of historical data, promoting data transparency and aligning the reporting of doctors and clinicians with other provider settings. While CMS cautions against direct year-to-year comparisons due to program and reporting standard variations, this historical data offers valuable insights for trend analysis and research purposes.
Accessing Care Compare and Staying Informed
Care Compare is readily accessible on Medicare.gov, serving as a central hub for comparing doctors, clinicians, and groups enrolled in Medicare. By publicly reporting performance information, CMS empowers patients to actively participate in their healthcare decisions and choose providers who align with their needs and preferences.
For any questions regarding public reporting for doctors and clinicians on Care Compare, the Quality Payment Program (QPP) Service Center is available via email at [email protected], through their online ticket system, or by phone at 1-866-288-8292.
To stay updated on the latest enhancements and news related to Care Compare and the Quality Payment Program, you can subscribe to the QPP and Care Compare: Doctors and Clinicians listservs. Embrace the power of information and utilize Care Compare to make confident and informed healthcare choices.
