'Physician Compare' Website: Keep It Current, Keep It Accurate, Academy Tells CMS

January 18, 2011 05:15 pm News Staff

The AAFP has called on CMS to ensure that the information provided on its new "Physician Compare(www.medicare.gov)" website, which was established according to provisions in the Patient Protection and Affordable Care Act, is accurate and up-to-date.

In a letter(2 page PDF) to CMS Administrator Donald Berwick, M.D., AAFP Board Chair Lori Heim, M.D., of Vass, N.C., said the AAFP has been a "longstanding advocate of quality improvement efforts." As such, the Academy acknowledges the value of and overall trend toward public performance reporting. But, said Heim, that information must be current and accurate.

The Affordable Care Act required CMS to establish, by Jan. 1, the Physician Compare website, which contains information on Medicare physicians and other eligible professionals who participate in the Physician Quality Reporting System -- formerly, the Physician Quality Reporting Initiative. CMS chose to use its existing Healthcare Provider Directory as a foundation for the Physician Compare website.

The Healthcare Provider Directory offers searchable information on physicians and other health care professionals by type of professional, specialty, location, gender, languages spoken, education and hospital affiliations. It also denotes Medicare participation and nonparticipation status.

"Given the agency's existing efforts, the Academy concurs with CMS' proposal to comply with this (Affordable Care Act) requirement by using the current Healthcare Provider Directory as the foundation for the Physician Compare website," Heim said.

But, she pointed out, "CMS largely bases the current Healthcare Provider Directory directly on information garnered through the Provider Enrollment, Chain and Ownership System, or PECOS."

"Unfortunately, the currency and accuracy of PECOS is highly suspect in light of the well-documented instances of Medicare contractor delays associated with the Medicare enrollment process," said Heim. "We … encourage CMS to promptly and drastically improve the Medicare physician enrollment process given its direct connection to the development of a Physician Compare website."

Heim pointed out that Medicare patients and their caregivers go online every day to learn details about Medicare benefits and identify physicians and other potential health care providers.

"AAFP therefore urges CMS to update this website as frequently as is feasibly possible," Heim said. "Frequent, perhaps monthly, updates would improve access to care by quickly connecting newly enrolled physicians or recently established practice locales with prospective patients."

Heim stressed that "prompt updates also serve to hasten the removal of inaccurate information."

In addition, she noted, in 2010, Congress repeatedly allowed Medicare payment cuts to temporarily take effect. When this occurs, CMS typically allows physicians to reexamine their Medicare participation status, according to Heim.

"Frequent updates to the Healthcare Provider Directory are especially needed during these all-too-frequent lapses by Congress so that physicians' decisions in this regard are accurately reflected on the (Physician Compare) site," said Heim.