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January 25, 2018

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CMS Drops Plan to Employ VM Checkmark on Physician Compare Website

January 12, 2016:

A key consumer tool the Centers for Medicare and Medicaid Services (CMS) proposed for Medicare’s Physician Compare website is being abandoned—for now. The tool in question was a checkmark reflecting the “value modifier” (VM) that would have offered consumers a way to compare the quality of care physicians provided as related to the costs of that care.

The decision was included in the final rule on payment policies under the physician fee schedule and other revisions to Part B for services rendered by most providers in calendar year 2016 that was published in the Federal Register in mid-November. CMS started applying the value modifier in calendar year 2015 to calculate differential payment for all physicians (participating and nonparticipating) in groups of 100 or more physicians paid under the Medicare physician fee schedule. Payment depends on the quality of care furnished as it relates to cost for given performance periods and participation in the Physician Quality Reporting System (PQRS).

A green checkmark next to a provider or practice’s name would have indicated an upward adjustment in the VM, indicating one of the following: higher quality care at a lower cost, higher quality care at an average cost, or average quality care at a lower cost. CMS was planning to implement the checkmark by late 2017 or early 2018, based on 2016 data.

Worries over whether consumers would adequately understand the import of a checkmark reflecting the VM or reach hasty conclusions about physician quality and cost that would not serve them well in the end persuaded CMS not to proceed with the tool for 2016. Among the concerns was the high proportion of physicians who would receive “average” scores and the absence of a checkmark for eligible providers (EPs) participating in programs that exempt them from the value modifier, which consumers could see as meaning the EPs provide inferior care.

A major objection to implementing the checkmark was that the VM adjustment will end after calendar year 2018 as the Merit-Based Incentive Payment System (MIPS) takes effect. Introducing a new indicator on the Physician Compare website only to possibly replace it soon after would only confuse consumers, commenters pointed out.

CMS has not completely nixed its plan to use a visual indication of an upward adjustment in quality of care. The agency holds out the possibility of evaluating such an indicator in the future.


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