The Wikileaks of healthcare: Could clinical quality transparency improve care?

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The Centers for Medicare and Medicaid Services began sharing physician-level outcomes data earlier this month on Physician Compare for 60 percent of physicians with the hopes of improving quality through transparent data.

The data includes information about physicians, accountable care organizations, group practices and hospitals. CMS tapped HealthLoop to drive patient satisfaction and better patient compliance for higher scores.

"This has been healthcare's WikiLeaks year," said HealthLoop CEO Todd Johnson. "We've never before seen such a dramatic turn toward data-driven medicine and patient access to information. Patient engagement has gone from buzzword to a real driver for outcomes in lower costs and increased quality."

In addition to CMS's Physician Compare, ProPublica launched a new wave of patient access outcomes data on the Surgeon Scorecard. Next year CMS plans to launch the first-ever mandatory outcomes-based payment program for joint replacements — the Comprehensive Center for Joint Replacement model — which will disclose physician outcome data.

There were 400,000 physicians included in the CMS Physician Compare launch that included star ratings based on whether the physician adhered to care standards for tobacco use, high blood pressure, depression, medications and heart disease and stroke prevention.

The idea is to help patients become more informed about their physicians and encourage adherence to best practices for quality care. But will it work?

The American Medical Association doesn't think so. Or at least not as the program currently stands.

The AMA wasn't happy when CMS moved forward with posting data on Physician Compare due to accuracy issues in the 2014 PQRS calculations and other issues with CMS' processes. Additionally, many providers are excluded from the website, which could lead patients to think excluded physicians don't meet the standards when, in fact, they do.

Additionally, physicians who don't participate in quality reporting face penalties next year and the AMA feels CMS didn't adequately educate physicians about those penalties.

"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," said AMA President Steven J. Stack, MD.

The Affordable Care Act required CMS to set up Physician Compare; whether patients will use it to physicians' benefit or detriment remains to be seen. CMS posted Hospital Compare statistics in 2014 to help patients learn more about the hospital surgical practices and healthcare-associated website. However, it seems as though not many hospitals are reeling as a direct result.

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