DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Medicare & Medicaid Services

Physician Compare

FACT SHEET
http://www.medicare.gov/find-a-doctor/provider-search.aspx

What Is Physician Compare?

The Affordable Care Act of 2010 requires the Centers for Medicare & Medicaid Services (CMS) to publicly report performance data about physicians and other health care professionals enrolled in the Medicare Program. Physician Compare makes this performance data available to Medicare beneficiaries to help them make informed choices about health care they get from Medicare providers.

This fact sheet describes the information contained in and resources available for Physician Compare.

What Can You Find on Physician Compare?

Physician Compare allows Medicare beneficiaries to search online for physicians and other health care professionals who serve Medicare patients. Information currently on the website includes:

Physicians’ and other health care professionals’ names, addresses, phone numbers, specialties, clinical training, and genders;

Whether physicians and other health care professionals write or speak languages other than English;

Hospital affiliation for physicians and other health care professionals; and

Whether physicians and other health care professionals accept the Medicare-approved amount as payment in full.

Physician Compare also includes information about physicians and other health care professionals who participate in the Physician Quality Reporting System and the Electronic Prescribing Incentive Program:

The Physician Quality Reporting System allows physicians and other health care professionals to report information to CMS about their Medicare patients who get care for specific medical conditions. Physicians and other health care professionals choose whether to report information through the Physician Quality Reporting System. Profile pages on Physician Compare will show whether physicians and other health care professionals participate in the Physician Quality Reporting System.

The Electronic Prescribing (eRx) Incentive Program encourages physicians and other health care professionals to use electronic prescribing to improve communication, increase accuracy, and reduce errors in prescribing. To participate in the eRx Incentive Program, physicians and other health care professionals must report their use of a qualified eRx system. Profile pages on Physician Compare will show whether physicians and other health care professionals participate in the eRx Incentive Program.

CMS regularly updates information on Physician Compare using feedback from the public and stakeholders through Town Hall meetings, Listening Sessions, e-mail sent to PhysicianCompare@westat.com, and the rulemaking process. Through rulemaking, CMS proposes new policies, including what type of information Physician Compare publicly reports during which years. The public also may comment on these proposals and offer CMS feedback about Physician Compare and the website’s direction.

What Is Next for Physician Compare?

CMS uses a phased approach to publicly report performance data at the group practice level. Using this approach, the public will have access to data from the 2012 Physician Quality Reporting System Group Practice Reporting Option (GPRO) on Physician Compare, when it becomes available.

Once published, beneficiaries may use GPRO data to determine whether group practices use best practices to treat common chronic conditions and offer effective preventive care. Physician Compare may report on the following conditions and types of medical care:

Diabetes,

Hypertension,

Coronary Artery Disease (CAD),

Heart Failure,

Ischemic Vascular Disease (IVD),

Chronic Obstructive Pulmonary Disease (COPD),

Care Coordination/Patient Safety, and

Preventive Care.

CMS will finalize plans for Physician Compare through the Physician Fee Schedule (PFS) rulemaking process as needed, and may include:

Adding quality of care information for group practices and, eventually, individual physicians and other health care professionals;

Adding information about participation in the Electronic Health Records (EHR) Incentive Program; and

Continuing to update information as regularly as possible.

Resources

For the Physician Compare website, visit http://www.medicare.gov/find-a-doctor/provider-search.aspx on the Internet, pictured below.

E-mail your feedback about the Physician Compare website to PhysicianCompare@westat.com.

For more information about the Physician Compare Initiative, visit http://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/physician-compare-initiative on the CMS website.

The Medicare Learning Network® (MLN) Educational Web Guides MLN Guided Pathways to Medicare Resources help providers gain knowledge on resources and products related to Medicare and the CMS website. For more information applicable to you, refer to the section about your provider type in the “MLN Guided Pathways to Medicare Resources Provider Specific” booklet at http://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNEdWebGuide/Downloads/Guided_Pathways_Provider_Specific_Booklet.pdf on the CMS website.

For all other “Guided Pathways” resources, visit http://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNEdWebGuide/Guided_Pathways.html on the CMS website.

This fact sheet was current at the time it was published or uploaded onto the web. Medicare policy changes frequently so links to the source documents have been provided within the document for your reference.

This fact sheet was prepared as a service to the public and is not intended to grant rights or impose obligations. This fact sheet may contain references or links to statutes, regulations, or other policy materials. The information provided is only intended to be a general summary. It is not intended to take the place of either the written law or regulations. We encourage readers to review the specific statutes, regulations, and other interpretive materials for a full and accurate statement of their contents.

The Medicare Learning Network® (MLN), a registered trademark of CMS, is the brand name for official CMS educational products and information for Medicare Fee-For-Service Providers. For additional information, visit the MLN's web page at http://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNGenInfo on the CMS website.

Your feedback is important to us and we use your suggestions to help us improve our educational products, services and activities and to develop products, services and activities that better meet your educational needs. To evaluate Medicare Learning Network® (MLN) products, services and activities you have participated in, received, or downloaded, please go to http://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNProducts and click on the link called 'MLN Opinion Page' in the left-hand menu and follow the instructions.

Please send your suggestions related to MLN product topics or formats to MLN@cms.hhs.gov.