Physician Compare, the CMS public reporting website, uses a five-star rating model to steer patients to providers who demonstrate value through high quality, low-cost and positive outcomes. As an ACO, ColumbiaDoctors’ data, and our “star scores,” will be published in late 2016 for 33 measures.
How will CMS generate the star ratings? Provider performance data will be drawn from the Consumer Assessment of Healthcare Providers and Systems (CAHPS), the Physician Quality Reporting System (PQRS), as well as ACO and claims data. CMS will set benchmarks based on the Achievable Benchmark of Care (ABC) methodology, which will be published on the website in 2017.
CMS is publishing this data to the public to encourage consumers to make informed decisions and to incentivize physicians to maximize performance. It is important to note that this information is available to download by virtually anyone, such as commercial payers who could use this information in contracted negotiated rates, Healthgrades, Google or other interested parties. Because we tend to treat sicker patients, our scoring may not reflect the true quality of care we provide leaving us susceptible to patient attrition away from ColumbiaDoctors by both payers and consumers.
CAHPS patient satisfaction performance will also be displayed using the five-star rating and a percent for the “top box” score for each summary survey measure. The top box score represents the percentage of responses in the most positive response category. The CAHPS survey asks patients to rate how often certain actions occur and to rate their satisfaction with those actions. The rating scales vary by question and include a “never” to “always” scale for frequency and a 0 – 10 scale for satisfaction with services provided. Questions are intended to derive information related to access, visit experience and how well their physician communicated with them.
For a list of the questions, visit http://acocahps.cms.gov/Files/SurveyInstruments/2015_ACO-12_Mail_Survey_English.pdf To learn more about Physician Compare, go to physiciancompare.gov, or contact the Quality division.