Physicians react warily to CMS proposal to release profiling data

The medical establishment is calling for some significant changes to the way that Medicare data will be released and used to evaluate physician performance.

In a letter to the Centers for Medicare and Medicaid Services (CMS), the American Medical Association and 81 specialty societies commented on a proposed rule that CMS published June 8. This rule addresses the release of Medicare Part A, B and D claims data for use in public physician quality reports. The Patient Protection and Affordable Care Act requires CMS to issue this data to qualified entities on the condition they combine it with private insurance information.

The AMA and its sister societies ask CMS to ensure that the data released is accurate and in a standardized format that can be compared with private insurance data. These standards should be applied specifically to risk adjustment and to attribution of data to the correct physicians, the societies say.

In addition, the societies note, physicians should have an opportunity to review the data on themselves before it is released. And they request that CMS ensure a "stringent overview of the review, appeals, and error correction process."

"Just as the release of reliable information can be helpful for patients and physicians, the release of incorrect information could harm patients and the entire Medicare system," Dr. Peter Carmel, president of the AMA, said in a press release. "The reports should compare apples to apples--using the same data from both private insurers and Medicare--and allow a full review and appeals process before publication, to provide the most accurate information." 

To learn more:
- read the societies' letter to CMS
- see the AMA press release
- see the article in Health Data Management