One of the primary functions of the Compare Tool is to offer insights into the quality of care provided by doctors and clinicians. CMS publicly reports Quality Payment Program (QPP) performance data on the tool, allowing users to see how doctors and clinicians perform across various quality measures. This information is available on the doctor and clinician profile pages within the tool and in the Provider Data Catalog (PDC). For the 2022 performance year, CMS added new QPP data, including final scores and performance under the Merit-based Incentive Payment System (MIPS) performance categories. This encompasses measure-level star ratings, percent performance scores, and checkmarks, offering a detailed view of performance.
To further assist patients, the Compare Tool now includes additional procedures data. In an ongoing effort to enhance transparency, CMS has expanded the utilization data available on the tool. Initially, in January 2024, procedure volume data for 12 common procedures, such as hip and knee replacements, cataract surgery, and colonoscopies, were added. By July 2024, this list expanded to include procedures like upper endoscopy, arthroscopy, varicose vein ablation, and laminectomy. This data reflects procedures performed for both Original Medicare and Medicare Advantage patients and provides valuable context about clinicians’ experience with these procedures.
Accessibility is a key consideration for CMS. Recognizing the increasing role of telehealth, a telehealth indicator has been added to doctor and clinician profile pages. This feature helps beneficiaries easily identify clinicians who offer telehealth services. This addition is particularly relevant in the wake of the COVID-19 pandemic, which highlighted the importance of remote healthcare options. The telehealth indicator ensures that patients seeking virtual care can readily find providers who offer these services.
Beyond individual clinicians, the Compare Tool also provides comprehensive facility affiliation information. In addition to hospital affiliations, the tool now includes affiliations with other facility types such as Long-Term Care Hospitals (LTCHs), Skilled Nursing Facilities (SNFs), Inpatient Rehabilitation Facilities (IRFs), Home Health Agencies, Hospices, and Dialysis Facilities. This update establishes crucial linkages between clinicians and facilities, offering a broader picture of a provider’s network and practice settings. This is especially helpful for patients requiring coordinated care across different types of healthcare facilities.
For users interested in historical data, CMS has expanded the archive for doctors and clinicians in the Provider Data Catalog. Previously, only one year of MIPS performance data was publicly available at a time. The expanded archive now allows access to historical MIPS performance data dating back to the program’s inception in 2017. This is a valuable resource for researchers, clinicians, and anyone interested in tracking performance trends over time. However, CMS advises caution against making direct year-to-year comparisons due to program and reporting standard changes.
Privacy is also addressed within the Compare Tool. Doctors and clinicians who primarily offer telehealth or non-patient-facing services from their homes can suppress their street addresses from public view on the profile pages. By marking their address in the Provider Enrollment, Chain, and Ownership System (PECOS) as a “Home office for administrative/telehealth use only,” or by contacting the QPP Service Center, clinicians can protect their personal contact information while still being searchable by city, state, and zip code.
In conclusion, the Medicare.gov Compare Tool is a powerful resource for anyone seeking to compare Medicare providers and make informed healthcare decisions. From quality performance data and procedure volumes to telehealth indicators and facility affiliations, the tool offers a wealth of information in an accessible format. By utilizing the Compare Tool, patients and caregivers can confidently navigate their Medicare options and choose the best care providers to meet their needs. For any questions or further assistance, the QPP Service Center is available via email, phone, and online ticket system, ensuring support is readily available to all users.
