CMS posts physician performance data despite serious issues

Troy Parks
Staff Writer
AMA Wire
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The Centers for Medicare & Medicaid Services (CMS) has released new performance scores on its Physician Compare website, despite miscalculations of quality data that resulted in the exclusion of many physicians. The move gives an unreliable picture that could mislead patients who use the tool to make choices about the health care they receive.

Patients misinformed

In recent months, the AMA became increasingly aware of miscalculations with the Physician Quality Reporting System (PQRS) scores. Despite these problems, CMS moved ahead with posting information only for about 40,000 physicians, while thousands more were excluded as a result of data submission and CMS miscalculations that produced inaccurate performance assessments.

In a Dec. 1 letter (log in) to CMS, the AMA had called on the agency to abandon plans to publish quality performance data this year. “[G]iven the widespread issues with 2014 PQRS calculations and feedback reports, the AMA believes it is extremely premature for CMS to expand Physician Compare to individual measures on profile pages,” the letter stated.

“The data inaccuracies and difficulties with CMS' processes grew over the last couple of months and, while CMS has acknowledged these problems, it has failed to address the underlying issues,” AMA President Steven J. Stack, MD, said in a statement Thursday. “The AMA is a strong supporter of transparency, but today's action goes in the opposite direction—offering the public information that will lead consumers to draw faulty inferences about the quality of care that an individual physician or group provides.”

CMS problems may lead to physician penalties

As an additional consequence of these data inaccuracies, many physicians are facing penalties in 2016. Poorly executed communications from CMS also mean that many physicians are unaware that they are in danger of penalties or that there is a fast-approaching deadline to file an appeal.

Physicians only have until Dec. 16 to avoid Medicare payment penalties of 2-4 percent. The AMA continues to press the agency to protect physicians from payment penalties that stem from these data issues.

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Patrice Harris, MD
Dec 01, 2016
Donald Trump’s cabinet secretary pick would bring the insight of a longtime physician and a willingness to listen to organized medicine’s concerns.