In 2017, during a forum held at the AAOS Annual Meeting, representatives from U.S. News & World Report introduced the publication’s plan to publish individual hip and knee surgeon performance analyses. The purpose, they explained, is to provide patients with decision support and better reflect the quality of care that orthopaedic surgeons provide (see U.S. News & World Report to Publish Hip and Knee Surgeon Ratings, AAOS Now, May 2017). The outcomes-based analyses have not yet been published, as the ratings methodology is still in development, with AAOS and other stakeholder societies continuing to provide input and feedback.

Recently, the publication shared with AAOS two additional updates to its physician-level public reporting activities. Both are separate and distinct from the hip and knee surgeon performance analyses, according to Ben Harder, chief of health analysis and managing editor of U.S. News & World Report.

Courtesy of U.S. News & World Report

Procedure-volume information

U.S. News & World Report’s online
physician profiles, available at www.usnews.com/doctors, now include volume information about many of the procedures that specialists, including orthopaedic surgeons, perform on Medicare patients.

Each procedure listed on a physician’s profile was performed by that physician a minimum of 11 times during the most recent year for which Medicare data were available. Physicians are identified as high-volume providers of a particular procedure if they performed it more frequently than at least 80 percent of their peers.

“To protect patient privacy, the Centers for Medicare & Medicaid Services (CMS) releases physician-level procedure counts only for counts of 11 or greater,” said Mr. Harder.

“For example, orthopaedic surgeons who performed at least 11 hip replacements, knee replacements, and other procedures in the Medicare population during the year are indicated on their profiles as providers of those services. It’s worth noting that CMS releases data at the billing code level, which, in some cases, we have rolled up into clinically meaningful categories, such as shoulder arthroplasty. As a result, a physician might not be identified as a provider of a certain procedure if he or she billed fewer than 11 procedures within each relevant billing code,” he added.

U.S. News & World Report expects to update physicians’ procedure-volume information annually. It acknowledges that because the information is based solely on Medicare data, it may not be wholly representative of physicians’ practices.

Patient-experience data

U.S. News & World Report also began publishing patient-experience ratings on its website in collaboration with Binary Fountain, a provider of patient feedback management solutions that collects patient reviews from more than 100 publicly available online sources. The data have recently appeared on many orthopaedic surgeons’ profiles, as well as on the profiles of physicians in numerous other specialties, according to Mr. Harder.

“It’s important to note that neither we nor Binary Fountain collected reviews directly from patients,” he said.

Binary Fountain scores and aggregates the review data to produce a rating for 10 categories, which represent the qualities patients value most when evaluating physicians, according to a study conducted by independent researchers. The categories are:

1. thoroughness of examination
2. ability to answer questions
3. clarity of instructions
4. provider’s follow-up
5. amount of time with patient
6. provider’s attitude
7. provider’s past success
8. provider’s reputation
9. inclusion in decisions
10. timely return of results

Using a weighted model, Binary Fountain combines the scores for each of the categories to calculate an overall patient-experience score. That score is then translated into a rating (excellent, very positive, positive, or fair) (Fig. 1).

AAOS response

“Although we appreciate U.S. News & World Report’s intentions, we want to make it very clear that the Academy does not endorse these activities,” said AAOS President David A. Halsey, MD. “Until there is good, meaningful data on physician performance collected through qualified clinical data registry activities, we remain concerned that the information would be biased—although not purposely—and incomplete. We support empowering patients with information that is based on valid and rigorously analyzed data obtained from registry sources.”

For more information about U.S. News & World Report’s procedure-volume and patient-experience methodologies, visit https://bit.ly/2MJNB3S.

Maureen Leahy is assistant managing editor of AAOS Now.

References:

1. Parrish B, Vyas AN, Douglass G: Weighting patient satisfaction factors to inform health care providers of the patient experience in the age of social media consumer sentiment. Patient Experience Journal. 2015;2:82-92.