GAO is urging the Centers for Medicare and Medicaid beef up its approach to physician quality reporting, recommending CMS be more methodical in order to make the reports more reliable.
GAO also recommended CMS find out why some physicians may not have read the reports and said it should ask a sampling of physicians about the reports' usefulness and reliability.
CMS officials agreed with the recommendations.
The Medicare Improvements for Patients and Providers Act of 2008 (MIPPA) directed the Department of Health and Human Services to develop a program to give physicians confidential feedback on the resources used to provide care to Medicare beneficiaries.
In response, CMS, an agency of HHS, implemented the Physician Feedback Program by distributing feedback reports to an increasing number of physicians that provided data on resources used and the quality of care.
The Medicare law mandated that GAO conduct a study of the program.
GAO identified:
- Methodological challenges CMS faces in developing feedback reports and approaches CMS has tested to address them: and
- Challenges CMS faces in distributing feedback reports and CMS plans to address them. GAO interviewed CMS officials and representatives from the program contractor and reviewed relevant documentation.
“CMS faces challenges incorporating resource use and quality measures for physician feedback reports that are meaningful, actionable, and reliable,” GAO concluded in its report, released Aug. 12.
CMS also faces challenges distributing feedback reports to physicians that its plans for improvement may not entirely address, GAO noted. In the most recent phase of the program, about 82 percent of physicians in CMS’s sample were not eligible to receive a report after CMS’s methodological decisions were applied.
