November 2, 2010

Federal Physician Comparison Website Coming

CMS has until January 1 to create the new site, intended to make it possible to lookup info on your doctor and compare her quality to that of others. Like launched recently, the notion is that these sites will create the incentive for providers to give better care, ultimately helping to control healthcare costs. As required by the Affordable Care Act, CMS has two years to get the site serving up quality data on docs.

Not only must quality data be available to help patients make smarter healthcare purchasing decisions, but the Act requires that the site help physicians to actively use the information to improve quality.

At a five-hour-long Town Hall last week, CMS gathered doctors, hospitals, employers and anyone else who wanted to participate with the goal of getting input on what the site should contain. The outspoken participants told them, among many other things:
  • Physician's sex, race and age
  • Languages spoken
  • Office hours
  • Medical degrees and schools
  • Hospitals where they have privileges
  • How long in practice
  • Health networks they belong to
  • Awards received
  • Community service work/care for the poor
Then, of course, there's the quality data coming in 2013. What will that look like? Will physicians who serve sicker populations appear to produce poorer results, or will there be some way to "risk-adjust" so that patients can make apples-to-apples comparisons?

And here's a big one: Should physicians' charges be disclosed? How can you make a value decision without prices? Doctors who charge more might offer additional services; what about house calls, or no-wait appointments, or a Personal Health Record (PHR) portal -- should this information be available?

Naturally, the AMA is pushing back a bit. AMA president James Rohack, M.D. told HealthLeaders Media last week that the AMA's concern is that "individual doctor-level data right now is not ready for prime time, especially in complex situations. The attribution of who's really responsible for that care is not worked out." Dr. Rohack said that doctors aren't particularly afraid of being graded: "The reason we became doctors was because we got good grades."

These and many more questions remain to be resolved even before determining exactly what data will be collected -- a step that is mandated to begin in January of 2012. But pulling away the veil of mystery surrounding the work of the physician is long overdue and worthy of the gargantuan task facing CMS. Unless a wing nut Congress repeals or guts the law within the next two years, we will finally be able to look under the hood before making some of the most important and most costly buying decisions of our lives.

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