Public performance report law needs tweaking, groups say

August 17, 2011

The response period for the government plan to make public reports on physicians? performance may be over but not before numerous medical associations expressed some concerns. Find out why more than 80 physician organizations called for measures to increase the accuracy of the information and to allow you more opportunity to review your own data.

The response period for the government plan to make public reports on physicians’ performance may be over, but not before numerous medical associations expressed some concerns.

The American Academy of Family Physicians, the American College of Physicians, the American Medical Association and 79 other physician organizations sent a letter to Donald Berwick, MD, administrator of the Centers for Medicare and Medicaid Services (CMS) calling for measures to increase the accuracy of the information and to allow more opportunity for doctors to review their own data.

Recognizing a certain inevitability about the rule, the letter states that public reports must be “valid, reliable and actionable for patients, physicians, and all stakeholders.”

With a likely January 1, 2012, implementation date, the Availability of Medicare Data for Performance Measurement proposes new statutory requirements regarding the release and use of standardized extracts of Medicare claims data to measure the performance of providers and suppliers while also protecting patient privacy, according to CMS. This proposal implements a requirement under the Patient Protection and Affordable Care Act that mandates Medicare Parts A, B, and D claims data be released for performance measurement.

The letter recommends that any publicly reported information must be:

appropriately risk-adjusted;
correctly attributed to those involved in the care; and
accurate, user friendly, relevant, and helpful to the consumer, patient, physician, or other stakeholder.

“Moreover, an important aspect of a quality reporting program is that physicians have the opportunity to review their data that forms the basis for any public report,” the letter states. “Physicians and other providers must have the opportunity for prior review and comment, along with the right to appeal, with regard to any data or its use that is part of the public review process.”

The American College of Cardiology also weighed in with another letter expressing concern that “the proposal to allow physician review of the data related to these performance measures does not provide significant opportunity for physician review and comment as required by the statute. While physicians are given an opportunity to review the data, CMS only proposes as little as a 10-day period in which to review what may be thousands of records covering a period of 2 to 3 years. This is not nearly enough time to review data and point out errors to the qualified entities.”

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