CMA Urges Physicians to Correct Data Used to Grade their Performance
This week, some 13,000 California physicians will be sent letters from the California Physician Performance Initiative (CPPI). These letters contain raw and relative performance scores for physicians on 16 quality measures based on claims data from United Health, Anthem Blue Cross, and Blue Shield PPOs as well Anthem Blue Cross and Blue Shield HMOs. The letters do not contain the underlying data.
CMA continues to have concerns about the accuracy and integrity of the data used to establish these scores and the potential use of these scores by payors for pay-for-performance, economic profiling, or tiered networks. In order to address some of CMA’s concerns and to improve the quality of the data, CPPI has again provided a reconsideration process that physicians can use to verify their data.
CMA urges all physicians who receive the letter to request their data from CPPI and verify its accuracy. Instructions for doing so are available here. The deadline to request your patient data is September 4, but CMA urges you to do so as soon as possible. Physicians must submit their corrected data by September 18.
In checking the data, physicians should check whether CPPI correctly listed the patient name, physician name and specialty, and whether the physician performed the procedure. If you did not perform the procedure, make sure to indicate why the particular metric does not make sense as a measurement of the quality of care you provided to your patient.
We understand that this may be a time-consuming process, but it is critical for physicians to take the time to verify their data. If you do not raise concerns now, payors could use this data in the future to adjust your reimbursements and change the flow of patients to your practice.
Once you have completed the reconsideration process, please also take CMA’s online survey to tell us what, if anything, was wrong about your performance scores. This step is important to ensure that CMA has the information needed to advocate on your behalf.
CMA is working with CPPI to identify individual CMA physicians impacted by this report so that we can assist members with the data reconsideration process.
CMA is also hosting webinars on this issue to help physicians understand the program and what they need to do to ensure the accuracy of the data being used to grade their performance. Currently, webinars are scheduled for the following dates/times.
Contact: Armand Feliciano, 916/551-2552 or afeliciano@cmanet.org. |
