System grading doctors is inefficient, needs revisions
A system created to grade doctors and empower patients to make better decisions falls short of its goal of providing information useful to consumers, according to a study by University of Michigan researchers.
"Physician Compare," a website by the Centers for Medicare and Medicaid Services, was set up to increase transparency and empower patients and caregivers on quality of care. The site is now on its final phase of expansion and has focused on adding clinician-level performance data, in addition to the data previously added about the performance of groups of physicians.
Jun Li, a doctoral candidate in the Department of Health Management and Policy at U-M's School of Public Health, and colleagues analyzed records of more than 1 million U.S. providers caring for Medicare beneficiaries.
They found that less than a quarter of providers have quality information on Physician Compare and only 1 percent have clinician-level quality information.
"This study is important for two reasons," she said. "First, patients and caregivers want information to be able to make informed choices. Thus, it is important to determine whether that need is being met. Additionally, federal policymakers are expending a great deal of resources toward Physician Compare, therefore it is imperative that we know how well it is functioning and whether it needs to be improved."
Among the team's key findings:
- Three quarters of clinicians have no performance data in the system
- 99 percent of those in the system have no clinician-level data
- Performance reflects only a narrow view of quality indicators such as safety, patient satisfaction and communication
To increase the reliability of the system, the researchers suggest considering major revisions to the website, or determining whether a different approach might help achieve the Department of Health and Human Services' goal of increasing transparency around the quality of health care.
For their analysis, the researchers used data from the Physician Compare National Downloadable File and the 2015 Medicare Data on Provider Practice and Specialty database, and included 1,025,015 U.S. providers caring for Medicare beneficiaries.
More information: Jun Li et al. Assessing the Quality of Public Reporting of US Physician Performance, JAMA Internal Medicine (2019). DOI: 10.1001/jamainternmed.2019.0398