The federal government is planning a study that will rate the more than 300,000 physicians who treat Medicare patients on the quality of their patient care, a top administration health official said.
The proposed federal budget that takes effect Oct. 1 includes funds for preliminary work on the study, which is expected to take several years to complete. The study, as now envisioned, would rate doctors by name and the results would eventually be made public.The study will be similar to the data on the mortality rates of nearly 6,000 hospitals, published in each of the last two years, and a forthcoming study on the quality of care in 15,000 nursing homes, to be made public this fall. The hospital studies were conducted to provide the public with information regarding the quality of care and to enable patients to make better-informed decisions on where to obtain health care.
"We plan to measure the performance of individual physicians by seeing how well their patients do," said Dr. William L. Roper, administrator of the Health Care Financing Administration in the Department of Health and Human Services. Health officials have not said how they plan to present their findings to the public. The hospital studies were made available through the Government Printing Office.
"There are differences in the quality of care given by physicians and hospitals," Roper said. "We can measure those differences, and that information should be conveyed to the public."
Roper noted that there were many factors to be considered in rating physicians, including mortality rates, speed of recovery, and complexity and severity of illnesses. "We'll need to adjust for the severity of the caseload," Roper said, "but it's definitely do-able."
The exact methodology for the study, the specific factors to be considered and how the evaluation would be expressed have not yet been determined.
Roper said that the study was within the competence of HHS, and that the needed data was easily obtainable. When the hospital studies were released, they stirred considerable debate in the health care field over whether results fairly compared individual hospitals.
The studies, which compared hospitals according to mortality rates, have been criticized by some hospital officials who said the studies failed to take into account factors such as the number of high-risk patients treated or the number of trauma or emergency cases served at a given hospital.
Nevertheless, federal officials have defended the release of the studies as useful to hospital staffs and consumers as a screening tool for evalaluating a hospital's strengths and weaknesses.
"There's been a hesitancy on the part of folks in the health care industry to give this information out on the grounds that it is flawed," Roper said, referring to data about physicians and hospitals. "But the perfect should not be the enemy of the good."
He said that the government was now collecting an enormous amount of data on physicians' and their Medicare patients, which will be used in the study. Roper's agency is responsible for Medicare and Medicaid reimbursement of hospitals and physicians. He noted that 31 million Medicare beneficiaries had 10 million hospital admissions last year, and 250 million "physician interactions."