The Centers for Medicare & Medicaid Services (CMS) is committed to transparency and empowering patients with the information they need to make informed healthcare decisions. A key part of this commitment is the Medicare.gov compare tool, often referred to as Cms Compare. This invaluable resource publicly reports performance information for doctors, clinicians, groups, and Accountable Care Organizations (ACOs), all readily accessible on Medicare.gov and through the Provider Data Catalog (PDC). Staying informed about the latest updates to CMS Compare ensures you are leveraging the most current data available.
Recent Enhancements to CMS Compare: What’s New?
CMS continuously updates the CMS Compare tool to enhance its functionality and data offerings. Here’s a rundown of recent improvements designed to provide a more comprehensive and user-friendly experience:
Expanded Procedure Data for Doctors and Clinicians
In its ongoing effort to increase transparency regarding clinician experience, CMS Compare has significantly expanded the procedure data available. Initially, in January 2024, CMS Compare included procedure volume data for 12 key procedures. Now, as of July 2024, this list has grown to include six additional procedures, providing a richer dataset for patients and caregivers.
The initial procedures covered in CMS Compare included:
- 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 update to CMS Compare added the following procedures:
- Upper endoscopy
- Arthroscopy – upper extremity
- Arthroscopy – lower extremity
- Varicose vein ablation
- Laminectomy/laminotomy (lumbar)
- Lower limb revascularization
This expanded data on CMS Compare reflects procedures performed for Original Medicare and Medicare Advantage patients within the preceding 12 months, with a three-month claims processing period to ensure data accuracy. CMS plans to continue adding more procedures to CMS Compare periodically, further enriching this valuable resource.
For a complete list of procedures and detailed background information, you can refer to the “Utilization (Procedure Volume) Data Published on the Compare Tool on Medicare.gov July 2024” fact sheet (PDF, 386.64 KB). The latest procedure volume data file is also available within the doctors and clinicians datasets on the PDC.
2022 Quality Payment Program (QPP) Performance Data Integrated into CMS Compare
The CMS Compare tool now features 2022 Quality Payment Program (QPP) performance information. This crucial data encompasses doctors, clinicians, groups, virtual groups, and ACOs. This integration allows users to assess clinician and group performance within the QPP directly through CMS Compare.
Reporting 2022 QPP performance on CMS Compare is a CMS requirement, showcasing MIPS eligible clinicians’ final scores and performance across MIPS performance categories. It also identifies clinicians participating in Advanced Alternative Payment Models (APMs) and their performance, where feasible. Performance data on CMS Compare is presented using star ratings, percentage scores, and checkmarks for easy interpretation.
By making 2022 QPP data publicly available on CMS Compare, CMS empowers Medicare beneficiaries and caregivers to evaluate and select healthcare providers based on performance metrics.
Telehealth Indicator Now Featured on CMS Compare
Recognizing the increasing importance of telehealth, CMS Compare now includes a telehealth indicator on doctor and clinician profile pages. This feature helps users quickly identify clinicians offering telehealth services.
The addition of the telehealth indicator to CMS Compare reflects the expanded role of telemedicine, especially following the COVID-19 public health emergency. This enhancement on CMS Compare directly addresses the need for accessible telehealth information, making it simpler for patients to find providers offering remote care options.
For further details, consult the “Telehealth Indicator on Medicare Care Compare: Doctors and Clinicians Public Reporting” fact sheet (PDF, 583 KB).
Enhanced Facility Affiliation Information on CMS Compare
CMS Compare has been updated to provide more comprehensive facility affiliation information for doctors and clinicians. Beyond hospital affiliations, CMS Compare now includes affiliations with:
- Long-Term Care Hospitals (LTCHs)
- Skilled Nursing Facilities (SNFs)
- Inpatient Rehabilitation Facilities (IRFs)
- Home Health Agencies
- Hospices
- Dialysis Facilities
These expanded affiliations on CMS Compare are linked directly from clinician profiles to the respective facility profiles. This improvement offers a more holistic view of a clinician’s practice and strengthens the connections between clinician and facility quality data within CMS Compare. This update is especially valuable for patients seeking care outside of traditional hospital settings.
Expanded Data Archive for Doctors and Clinicians in CMS Compare’s Provider Data Catalog
The Provider Data Catalog (PDC), linked with CMS Compare, now offers an expanded archive of data for doctors and clinicians. This archive provides access to historical Merit-based Incentive Payment System (MIPS) performance data dating back to the program’s inception in 2017.
Previously, CMS Compare and the PDC displayed only one year of MIPS performance data at a time. The expanded archive in the PDC linked from CMS Compare now allows users to access a broader range of historical data, benefiting researchers, clinicians, and anyone interested in longitudinal performance trends. This increased historical data availability through CMS Compare and the PDC supports greater data transparency.
However, CMS advises caution against direct year-to-year performance comparisons using this historical data due to changes in the MIPS program and public reporting standards over time. For more details, refer to the “MIPS Data Archive on Care Compare: Doctors and Clinicians” fact sheet and disclaimer (135 KB) (PDF).
Address Suppression Option for Telehealth Providers on CMS Compare
To protect the privacy of clinicians providing telehealth or non-patient-facing services from their homes, CMS Compare offers an address suppression option. Doctors and clinicians can suppress their street addresses on their CMS Compare profile pages if they provide services from their residence.
Clinicians can designate their home address as a “Home office for administrative/telehealth use only” in the Provider Enrollment, Chain, and Ownership System (PECOS) to automatically suppress street address details on CMS Compare. Alternatively, they can contact the QPP Service Center to request address and/or phone number suppression. Crucially, city, state, and zip code information remains visible on CMS Compare to ensure clinicians are still searchable and their performance data is reported.
This feature of CMS Compare balances privacy concerns with the need for public accountability and accessibility.
Leveraging CMS Compare for Informed Healthcare Choices
CMS Compare on Medicare.gov is a powerful tool designed to help patients and caregivers make informed decisions about their healthcare. By providing transparent data on provider performance, procedures, affiliations, and telehealth availability, CMS Compare enhances patient empowerment and access to quality care. Explore CMS Compare today to find the right doctors and clinicians for your needs.
Contact and Support for CMS Compare
For any questions regarding public reporting for doctors and clinicians on CMS Compare, please contact the Quality Payment Program (QPP) Service Center.
- Email: [email protected]
- QPP Service Center ticket: QPP Service Center ticket
- Phone: 1-866-288-8292 (Monday-Friday, 8 a.m. – 8 p.m. ET)
- Telecommunications Relay Services (TRS): Dial 711
For updates on CMS Compare and related programs, subscribe to the QPP and Care Compare: Doctors and Clinicians listservs: subscribe.
