AMA Criticizes CMS Release of Physician Quality Data

The American Medical Association is charging that performance data and new quality measures posted by CMS that rate the nation’s physicians are incomplete, potentially inaccurate, and likely to misinform patients.


The Centers for Medicare and Medicaid Services on Thursday added performance data and new quality measures to its Physician Compare website to enable consumers to make more informed healthcare decisions.

However, the American Medical Association—as it has in the past—again is charging that CMS has posted incomplete and potentially inaccurate information to the online resource that will only serve to misinform patients.

Among the data added to Physician Compare, CMS posted 2014 clinical quality of care measures for more than 40,000 individual healthcare professionals who reported as part of the Physician Quality Reporting System (PQRS)—Medicare’s quality reporting program. The agency also posted 2014 clinical quality of care measures for approximately 275 group practices who reported as part of PQRS.

In addition, CMS posted measures for approximately 290 group practices who reported patient experience measures through the Consumer Assessment of Healthcare Providers and Systems (CAHPS) for PQRS survey, which asks Medicare patients for feedback regarding their experiences getting care from their group practice.

Also See: CMS Lays Out Vision for Physician Quality Reporting Programs

But, in a written statement, the AMA expressed its “dismay” with CMS for publicly posting what it calls “problematic” information on the Physician Compare website that the group worries will lead consumers to draw faulty inferences about the quality of care that an individual physician or group provides.

“Given the widespread accuracy issues with the 2014 PQRS calculations, the newly released information is premature,” said AMA President Steven Stack, M.D. “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. Most importantly, consumers visiting the Physician Compare website are likely to get a false impression that it provides accurate quality information for all physicians, when in fact, due to significant data problems, the newly added information covers only about 40,000 physicians.” 

Further, Stack claims that thousands of other physicians who provide similar services were excluded due to data problems. And, while CMS has attempted to “mitigate the situation by explaining that the data may not be comprehensive, and patients should not assume that doctors are deficient in areas where no information is provided,” he complained that the “location of the disclaimer may not be immediately obvious to patients.” 

Stack also pointed out that many physicians are unaware that they face penalties in 2016 based on 2014 PQRS reporting and for missing the deadline for contesting CMS calculations. “Many doctors will be flagged as failures and be subject to financial penalties as a result of CMS miscalculations or because they missed a poorly communicated appeal deadline,” he said.

Given that CMS performance calculations involving PQRS, Value-based Modifier and Physician Compare have been lacking, AMA is urging CMS to protect doctors from payment penalties as a result of these data issues. 

Information about the 2014 quality measures on the Physician Compare website can be found here in a CMS fact sheet.

More for you

Loading data for hdm_tax_topic #better-outcomes...