Still a work in progress

Providers skep­ti­cal of ac­cu­racy of CMS’ Physi­cian Com­pare web­site

Modern Healthcare - - THE WEEK IN HEALTHCARE - Andis Robeznieks

When he heard that the CMS had re­designed its Physi­cian Com­pare web­site, Dr. Dou­glas Den­ham checked it out. “Other than my name be­ing cor­rect and that I prac­tice in San An­to­nio, the rest of the in­for­ma­tion was in­cor­rect,” Den­ham said. “I’ve never been at that ad­dress in my life. I’ve never had that phone num­ber in my life.”

In­ves­ti­gat­ing fur­ther, Den­ham went to a site called Well­ that listed his prac­tice lo­ca­tion from about 13 years ago.

The Amer­i­can Med­i­cal As­so­ci­a­tion’s Doc­torFin­der data­base cor­rectly listed his phone num­ber and that Den­ham was an os­teo­pathic fam­ily physi­cian in San An­to­nio. But be­cause he’s not an AMA mem­ber, that’s about all it listed. Even Google is not Den­ham’s friend. A law firm in Port­land, Maine, whose lead part­ners have the last names of Dou­glas and Den­ham, gets listed in search re­sults for “Dou­glas Den­ham” ahead of his prac­tice’s web­site at abc­fam­i­ly­

The Physi­cian Com­pare web­site is in­tended to help con­sumers cut through that on­line noise. The site, called for un­der the Pa­tient Pro­tec­tion and Af­ford­able Care Act, went live in 2010 with a limited set of in­for­ma­tion. A re­vamped ver­sion launched last week adds an “in­tel­li­gent search” fea­ture and more in­for­ma­tion about the listed physi­cians.

A CMS of­fi­cial said the web­site is be­ing de­vel­oped in a phased ap­proach and is pro­ceed­ing ac­cord­ing to plan. The sched­ule calls for adding qual­ity mea­sures in 2014—the CMS has agreed to a 30-day preview pe­riod al­low­ing providers to re­view that in­for­ma­tion be­fore it is posted.

Den­ham said the mis­in­for­ma­tion about him on the Web is not a con­cern for him be­cause he prac­tices out of a large as­sist­edliv­ing fa­cil­ity and doesn’t rely on pa­tients find­ing their way to him on­line. But he fig­ures the govern­ment should be able to find the right in­for­ma­tion on him with­out too much trou­ble; most of his pa­tients are “re­tired mil­i­tary folks.”

Physi­cian Com­pare’s list­ings are based on the CMS-run Provider En­roll­ment, Chain and Own­er­ship Sys­tem (PE­COS). Pa­trick Mills, di­rec­tor of health­care fi­nance for the Mis­souri State Med­i­cal As­so­ci­a­tion, said any trou­bles with the web­site start there. “Check and recheck what’s on PE­COS, that’s the mes­sage we’re push­ing out,” Mills said. “That is the data­base that’s pop­u­lat­ing the con­tent of the web­site.”

One of the up­grades to Physi­cian Com­pare in­volves an “over­haul of the un­der­ly­ing data-

“CMS has the un­en­vi­able job of im­ple­ment­ing what’s been put out there leg­isla­tively.”

—Pa­trick Mills Mis­souri State Med­i­cal As­so­ci­a­tion

base,” which now cross-ref­er­ences in­for­ma­tion in PE­COS with Medi­care claims data from the pre­vi­ous 12 months. The re­designed web­site now in­cludes in­for­ma­tion on whether a physi­cian is par­tic­i­pat­ing in HHS’ fi­nan­cial in­cen­tive pro­gram for elec­tronic health records, board cer­ti­fi­ca­tion and af­fil­i­a­tions with hos­pi­tals and other pro­fes­sion­als. It also in­cludes a fea­ture for physi­cians la­beled “How to Keep Your In­for­ma­tion Cur­rent,” where up­dates can be made.

Un­like the Hos­pi­tal Com­pare web­site, which was launched in 2004 as some­thing of a pub­lic-pri­vate part­ner­ship be­tween hos­pi­tal as­so­ci­a­tions, govern­ment bod­ies and pri­vate or­ga­ni­za­tions such as the Joint Com­mis­sion, Physi­cian Com­pare was man­dated by the health­care re­form law. Pre­vi­ously, data was mostly limited to the physi­cian’s lo­ca­tion, spe­cialty, ed­u­ca­tion, lan­guages spo­ken and gen­der, which crit­ics noted was al­ready avail­able else­where on the In­ter­net.

“CMS has the un­en­vi­able job of im­ple­ment­ing what’s been put out there leg­isla­tively,” Mills said.

Dr. Reid Black­welder, pres­i­dent-elect of the Amer­i­can Acad­emy of Fam­ily Physi­cians, said his group has been send­ing in sug­ges­tions since the site launched. “It looks like some of the things we sug­gested were ad­dressed,” he said. “The search engine seems to do a bet­ter job.” For ex­am­ple, Black­welder said, the site re­turns list­ings for fam­ily physi­cians when users search for headaches or other gen­eral con­di­tions.

Al­li­son Bren­nan, se­nior ad­vo­cacy ad­viser for the MGMA, also said that it ap­peared the web­site’s func­tion­al­ity had im­proved. Bren­nan added, how­ever, that she had prob­lems with a pro­posed star-rat­ing sys­tem for qual­ity mea­sures that MGMA rep­re­sen­ta­tives were shown in Web page mock­ups in Jan­uary. She was also con­cerned with hav­ing physi­cians’ list­ings note whether they are ac­cept­ing new Medi­care pa­tients, which can change of­ten.

While Physi­cian Com­pare’s de­vel­op­ment is driven by the ACA, Hos­pi­tal Com­pare started as a vol­un­tary ef­fort by the Amer­i­can Hos­pi­tal As­so­ci­a­tion, Fed­er­a­tion of Amer­i­can Hos­pi­tals and As­so­ci­a­tion of Amer­i­can Med­i­cal Col­leges. Nancy Foster, AHA vice pres­i­dent for qual­ity and pa­tient safety, said that in­sti­tu­tions were fear­ful of a del­uge of dif­fer­ent data re­quests from com­pet­ing qual­ity web­sites. In re­sponse, they be­gan a uni­fied, vol­un­tary data col­lec­tion pro­gram in late 2003. Even­tu­ally, the CMS took over the en­ter­prise as it grad­u­ally linked in­cen­tive pay­ments to qual­ity re­port­ing.

Foster said she’s look­ing to see how much com­mon­al­ity the two web­sites will have be­yond the sim­i­lar­ity of their names. She said Physi­cian Com­pare’s im­por­tance will be de­ter­mined by how well it helps pa­tients make a choice be­tween doc­tors.

Cindy Mor­ri­son, ex­ec­u­tive vice pres­i­dent of mar­ket­ing and com­mu­ni­ca­tions for San­ford Health in Sioux Falls, S.D., said that any­thing the CMS may post about San­ford’s 1,400 em­ployed doc­tors has al­ready been posted by the or­ga­ni­za­tion it­self. She added that de­spite the myr­iad on­line sources of­fer­ing physi­cian in­for­ma­tion, a friend or rel­a­tive’s rec­om­men­da­tion is still the strong­est fac­tor in a pa­tient’s choice about which doc­tor to see.

Karen Zupko, pres­i­dent of Karen Zupko & As­so­ciates, a Chicago-based prac­tice man­age­ment con­sult­ing and train­ing firm, said a more hands-on ap­proach is needed to man­age a physi­cian’s Web pres­ence. “Prac­tices used to be built on word of mouth, now it’s word of mouse,” said Zupko, who rec­om­mends that a prac­tice have some­one in the of­fice reg­u­larly mon­i­tor sites such as Angie’s List, Health­Grades, Vi­, We­bMD and Yelp to see what’s be­ing posted.

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