Making informed decisions about healthcare is crucial, especially for Medicare beneficiaries. The Centers for Medicare & Medicaid Services (CMS) provides a valuable resource to assist in this process: the Medicare Care Compare tool. This online platform offers a wealth of information on doctors, clinicians, hospitals, and other healthcare providers, empowering patients and caregivers to make the best choices for their needs. Staying updated on the latest enhancements to this tool is key to maximizing its benefits.
Unveiling Expanded Procedure Data for Informed Decisions
CMS is continuously improving the Medicare Care Compare tool to offer more comprehensive data. Recently, significant updates have been made to include expanded procedure data, providing greater transparency into clinicians’ experiences. This enhancement is designed to help patients and caregivers gain a clearer understanding of the services offered by different providers.
In January 2024, CMS initially integrated procedure volume data for twelve key procedures. This included common surgeries and treatments such as hip and knee replacements, spinal fusion, cataract surgery, colonoscopies, hernia repairs, mastectomies, coronary artery bypass grafts (CABG), pacemaker procedures, coronary angioplasty and stenting, and prostate resections. This initial rollout marked a significant step forward in providing patients with tangible data to evaluate provider experience.
The latest update in July 2024 further expands this valuable resource by adding six more procedures to the Medicare Care Compare tool. The newly included procedures are upper endoscopy, arthroscopy for both upper and lower extremities, varicose vein ablation, laminectomy/laminotomy (lumbar), and lower limb revascularization. This expansion means beneficiaries now have access to utilization data for an even wider range of medical procedures when researching doctors and clinicians through the tool. This data reflects procedures performed within the previous 12 months for Original Medicare and Medicare Advantage patients, ensuring the information is current and relevant. CMS plans to continue adding more procedures to the Medicare Care Compare tool periodically, further enriching its value as a decision-making aid.
Accessing 2022 Quality Payment Program (QPP) Performance Insights
Beyond procedure data, the Medicare Care Compare tool also offers insights into provider performance through the Quality Payment Program (QPP). The 2022 QPP performance information is now available, providing valuable data for patients seeking high-quality care. This information encompasses doctors, clinicians, groups, virtual groups, and Accountable Care Organizations (ACOs).
CMS is committed to transparency and publicly reports MIPS eligible clinicians’ final scores and performance across various MIPS performance categories. The tool also identifies clinicians participating in Advanced Alternative Payment Models (APMs), and where possible, reports on the performance of these APMs. Performance data is presented in an easily digestible format using measure-level star ratings, percent performance scores, and checkmarks, making it simple for Medicare beneficiaries to assess and compare provider performance. By making this data public, CMS empowers patients to proactively engage in their healthcare choices and select providers who align with their quality expectations.
Telehealth Indicator: Connecting with Care from Anywhere
Recognizing the growing importance of telehealth, CMS has integrated a telehealth indicator into the Medicare Care Compare tool. This feature directly addresses the increasing demand for remote healthcare services and simplifies the process of finding providers who offer telehealth options.
The telehealth indicator is prominently displayed on doctor and clinician profile pages within the Medicare Care Compare tool. This visual cue allows beneficiaries and caregivers to quickly identify clinicians offering telehealth services, streamlining their search for accessible care. The expansion of telemedicine services, particularly accelerated by the COVID-19 pandemic, has highlighted the need for clear information about telehealth availability. This indicator is a direct response to that need, reflecting CMS’s commitment to providing patients with the information they need to navigate the evolving healthcare landscape and choose care options that best suit their circumstances.
Facility Affiliation Information: Gaining a Broader Perspective
Understanding a doctor’s affiliations can provide a more complete picture of their practice and network. The Medicare Care Compare tool now includes expanded facility affiliation information, offering beneficiaries a wider context when evaluating doctors and clinicians.
In addition to previously available hospital affiliations, the tool now displays affiliations with other facility types, including Long-Term Care Hospitals (LTCHs), Skilled Nursing Facilities (SNFs), Inpatient Rehabilitation Facilities (IRFs), Home Health Agencies, Hospices, and Dialysis Facilities. This enhancement creates valuable linkages between clinician profiles and facility profiles within the Medicare.gov ecosystem. By providing these connections, the tool empowers patients and caregivers to explore the broader network of care associated with a particular doctor or clinician. This is especially helpful for individuals requiring specialized or ongoing care across different healthcare settings.
Expanded Data Archive: Accessing Historical Performance Data
For researchers, clinicians, and anyone interested in long-term performance trends, CMS has expanded the data archive within the Provider Data Catalog (PDC) on Medicare.gov. This update provides access to historical Merit-based Incentive Payment System (MIPS) program performance data dating back to the program’s inception in 2017.
Previously, only one year of MIPS performance data was publicly available at a time. The expanded archive now allows users to delve into historical data, offering a more comprehensive view of performance trends over time. This is a valuable resource for those seeking to analyze program evolution, track performance improvements, or conduct in-depth research. While CMS cautions against direct year-to-year performance comparisons due to program and reporting standard changes, the availability of this historical data significantly enhances data transparency and supports a deeper understanding of the MIPS program’s impact over time.
Health Equity Focus: Ensuring Accessible Information for All
CMS is committed to health equity and ensuring that the Medicare Care Compare tool is accessible to all beneficiaries. The tool’s design and content are developed with a health equity lens, aiming to reduce disparities in access to information and care.
The Medicare Care Compare tool is designed with features that promote accessibility for diverse populations. This includes the use of plain language to ensure information is easily understood, user testing to optimize usability for individuals with varying levels of technical proficiency, and support for users who may not have internet access. Furthermore, the availability of a separate Spanish-language site demonstrates CMS’s commitment to reaching diverse linguistic communities. By proactively addressing potential barriers to access, CMS ensures that the Medicare Care Compare tool serves as an equitable resource for all Medicare beneficiaries, empowering them to make informed healthcare decisions regardless of their background or circumstances.
Contacting Support for Further Assistance
For any questions regarding public reporting for doctors and clinicians on the Medicare Care Compare tool, the Quality Payment Program (QPP) Service Center is available to provide assistance. Beneficiaries and providers can reach the QPP Service Center via email at [email protected], through the QPP Service Center ticket system, or by phone at 1-866-288-8292. Support is available Monday through Friday, 8 a.m. to 8 p.m. ET. For quicker service, especially during peak periods, calling during non-peak hours (before 10 a.m. and after 2 p.m. ET) is recommended. Telecommunications Relay Services (TRS) are also available for people who are deaf or hard of hearing by dialing 711. Stay informed about updates by subscribing to the QPP and Care Compare: Doctors and Clinicians listservs.
Medicare’s Care Compare tool is a powerful resource for navigating the complexities of healthcare choices. By staying informed about its latest updates and features, Medicare beneficiaries can leverage this tool to make confident decisions and access the best possible care.
