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Medicare Compare Updates Please Some, Not All

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  • August 11, 2011
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Now consumers can access all of Medicare’s Compare tools using the Quality Care Finder—a new tool that operates much like a one-stop shopping center for comparison information on hospitals, nursing homes, physicians, and more. The Centers for Medicare & Medicaid Services (CMS) announced the new tool in addition to an updated Hospital Compare website and enhancements to the Quality Improvement Program (QIO) on Aug. 5.

“These tools are new ways CMS is making sure consumers have information about health care quality and important information they need to make the best decisions about where to receive high-quality care,” said CMS Administrator Donald Berwick, MD. “These efforts are designed to also encourage providers to deliver safe, patient-centered care that consumers can rely on and will motivate improvement across our health care system.”
Consumers can now go to the Hospital Compare website to obtain data on hospital acquired conditions (HACs) rates. Potential future measures for the Hospital Value-Based Purchasing Program, and mortality and readmission measures for approximately 150 veterans administration hospitals also are posted on the site.
The updated data for outcomes of inpatient hospital care includes new 30-day mortality rates and 30-day readmissions rates for inpatients admitted with heart attack, heart failure, and pneumonia. These rates encompass three full years of claims data (from July 1, 2007 to June 30, 2010).
Hospital Compare also includes 10 measures that capture patient experience with hospital care, 25 process-of-care measures, and three children’s asthma care measures. Consumers can also find information about the volume of certain hospital procedures performed and conditions treated for Medicare patients and what Medicare pays for those services.

Health Reform Orders More Transparency

The health reform law requires CMS to expand the various Compare sites by adding performance information by 2013. In the Medicare Physician Fee Schedule 2012 proposed rule, CMS proposes to use information from the Physician Quality Reporting System (PQRS) program as a way to measure performance. The agency said it would publish the percentage at which a doctor reported performing particular clinical quality actions.
According to American Medical News (amednews), other upgrades are scheduled for completion by the end of 2012. “They include monthly data refreshes to incorporate updates, such as successful participants in the Medicare electronic prescribing and electronic medical record incentive programs, and links to specialty board websites that provide information on board certification status,” said amednews staffer Charles Fiegl.
Hospital Compare receives about 1 million page views each month, which pleases CMS, but concerns others. According to the American Medical Association (AMA), for example, physicians have criticized the site for mistakes and missing information since its debut in 2010.

CMS Updates Medicare Enrollment Form

Currently, the Physician Compare site displays the names and contact information of physicians enrolled in the Medicare program. The agency also posts information on whether a physician accepts the Medicare-approved amount on all claims. Information about whether the physician is accepting new Medicare patients, however, isn’t indicated. Officials working on the Medicare agency’s Physician Compare website had requested that the question be added for future versions of the online comparison tool, said CMS spokeswoman Ellen Griffith.
“We actually have received suggestions from both physicians and beneficiaries to add this element, since it is frustrating to beneficiaries to call physicians who are not accepting new patients and for those physicians to field those calls when they are not taking new patients,” Griffith told amednews.
In July, the agency updated form 855I, page 5, to include the question, “Do you accept new Medicare patients?” Physicians and nonphysician practitioners are now required to answer that question when enrolling in the Medicare program or updating their enrollment information. This information already appears in the Provider Enrollment, Chain, and Ownership System (PECOS), and will likely find its way to the Physician Compare site in the near future.

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