Thursday, April 9, 2015

Physician Compare and Quality Reporting—More Benefits Brought to you by the Affordable Care Act

Physician Compare and Quality Reporting—More Benefits Brought to you by
 the Affordable Care Act.
Dr. Michael Mileski, DC, MPH, MSHEd, LNFA

As many of you know, the Patient Protection and Affordable Care Act (ACA) came into being in 2010.  What many do not know is that the Act itself has had rolling implementation of many different benefits since then.  Each year has brought new and interesting policies to pass which benefits us as healthcare consumers.

One great benefit mandated by the ACA is the Physician Compare website.  Before this part of the Act passed, consumers had to rely upon information gathered by their own insurance companies, which could show some bias, or simply on word-of-mouth to find a good physician which met their needs.  Today, one can easily access the Physician Compare website at and be able to make great comparisons of physicians in their area by location, zip code, specialty, and a large number of other choices.

This site was mandated as a part of the Act for two main reasons: 1.) to allow consumers to make informed decisions about their providers of choice, and 2.) to incentivize physicians for maximum performance.  This incentive program was a choice previous to 2015 for physicians to take part in or not.  However, beginning in 2016 (based on 2015 data) physicians will be paid according to their own quality measure reporting via taking part in a “Physician Quality Reporting System.”  Those that chose to not take part will see smaller reimbursements for their services beginning in 2016.  Consumers can clearly
see which providers have chosen to take part in the quality reporting system when viewing them on the Physician Compare Website.Indeed, some interesting benefits for consumers as a result of the ACA. 

We will continue to see more things rolling out as we move towards full implementation in 2018.Some important websites with further information:

Centers for Medicare and Medicaid Services. (2014). Medicare FFS physician feedback program/Value-
based payment modifier.  Retrieved from:
Centers for Medicare and Medicaid Services. (2014). Physician compare overview.  Retrieved from:
Centers for Medicare and Medicaid Services. (2013). Physician quality reporting system (PQRS)
overview.  Retrieved from:


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