Medicare's Website Overhaul: A Step in a Better Direction

When Medicare made the 2012 announcement that they'd developed a new system in which they'd determine an individual physician's reimbursement payment based on their measured "quality of care," many experts and physician's found themselves squeamish about their overly simplistic approach to the process. The underlying question "what constitutes quality of care?" had many questioning the organization's motives and scope, and their preliminary system of payment and judgment seemingly failed to account for many factors. However, a more recent Medicare announcement shows that the organization's insistence on streamlining medical processes isn't always a hot button proclamation with a laundry list of caveats.

The medical juggernaut's newest development, an intuitive website overhaul, does seem to provide the argument that some (albeit, not all) processes in a "nearly-ACA" America may be getting smoother, more all-inclusive and beneficial to doctors and patients alike. "Give me convenience, or give me death," goes the adage (with a modern spin by yours truly) and it's with this attitude that Medicare makes many of their site adjustments. The arduous task of locating and comparing physicians is simplified, and the system genuinely improves.

A Better Website
Medicare's online directory of participating physicians has been tweaked and redesigned in an effort to improve the accuracy of the site's information, and also to render the search function more user-friendly. After numerous errors were discovered on the site following its initial launch in December 2010, Centers for Medicare & Medicaid Services (CMS) began overhauling the site, utilizing technicians to address the issues and to build new and more handy features for patients to use when searching for medical care. The new and improved version of the site went live on June 27th of this year.

This effort to serve the nearly one million physicians and healthcare professionals who serve the Medicare population will, according to CMS administrator Marilyn Tavener, "provide new information in an improved, easy-to-use format." Many of the site's changes have come from the American Medical Association's help, and the two have worked together to fix major hiccups within the site like incorrect addresses and false listings which show physicians at practice locations they left years ago. Physicians have also been enlisted to ensure that the directory is accurate and useful to all Medicare beneficiaries and participating doctors. The website was a requirement of the Affordable Care Act. Here's a closer look.

More Ways to Find Care
One of the website's many improvements is a more 'intelligent" search function. Patients can search for physicians in their area using a zip code, city, state and address. However, an impressive new feature also allows patients to search simply via geographic landmarks like malls or parks. Users may also find physicians by last name, medical specialty or a particular medical condition. As an example, patients searching for the term "rash" will be prompted with a drop-down menu box with which they can then choose a doctor specializing in allergy or immunology, dermatology, infectious disease or rheumatology.

There's even an interactive search function, billed under Medicare's "Physician Compare" system, which allows users to search for physicians and physician specialties by constituent body parts. They simply use their mouse to click on a specific part on a simulated human body. This in turn brings up a list of physicians in their area specializing in ailments and treatment for the chosen body part. These include the head, neck, chest, arms, abdomen, hands, back, groin, skin and legs.

More Accurate Updating
The physician information still utilizes CMS Provider Enrollment as its base, but improves upon the error-prone system of the past. Charles Fiegl's recent Amednews article, Medicare's Doctor Records Riddled with Errors cites federal auditors in reporting that false addresses, outdated phone numbers and incorrect licensing information have been a huge component of the enrollment systems which Medicare uses to approve pay for beneficiary services. An estimated 58% of enrollment records in the Provider Enrollment, Chain and Ownership System were inaccurate, and 48% of records in the National Plan and Provider Enumeration System had errors, the Department of Health and Human Services Office of Inspector General stated in a report published May 28. The records also were inconsistent between the two systems, with nearly all records for health professionals in PECOS and NPPES containing mismatched information in 2010. The new Medicare site aims to dissolve these types of errors by constantly updating entries. PECOS is still the primary data source but they're also enlisting the help of individual physicians and their claims. For example: addresses that have been submitted on reimbursement claims can be cross-referenced with any existing data to help to verify the addresses as they appear on the website, and to slough off old and incorrect entries that clog up the search function. This also ensures that only active physicians and healthcare professionals are included on the site, as it only includes those who are currently billed (within the preceding 12 months).

These physician submitted entries will also be updated on a quarterly basis, so when a physician moves to a new practice location, it will show up correctly on the site much more quickly and won't get lost in the shuffle. Corresponding physicians will also have profile pages that include information on Medicare incentive programs such as quality reporting, electronic prescribing and their use of electronic health records.

More Accessibility
The extensive site makes an additional claim for itself by its accessibility on platforms outside of just a desktop computer site. It's got interactive mobile variations and a responsiveness, ideal for tablets and smart phones, meaning that the process of using the site can be one that's simple and predicated for "on the go" patients. Since the underlying goal of the site improvement is to enhance the user experience, patients, users and physicians, now don't have to worry about getting lost deep within its complicated set-up.

Public Reporting Infrastructure
According to CMS, one of the most prescient enhancements of the overhaul is the new emphasis on public reporting infrastructure. The site is designed with the user experience in mind, and so a culture of "constantly improving and enhancing" has been established in order to continually diminish errors, enhance its capabilities and ultimately create a stronger and better resource for all who use it.

Many still believe that the proverbial kinks of the Affordable Care Act have yet to be properly addressed, and even more await the new physician-insurance-reimbursement climate that will await them when the law takes effect. The overall advantages and disadvantages of the Affordable Care Act are not any less hotly debated among scholars and physicians, but at the very least many can agree that this site (itself a requirement of the ACA) is striving to make a bitter pill somewhat more palatable.


CMS. "Physician Compare Redesign."
Centers for Medicare & Medicaid Services, 17 June 2013. Web. 14 July 2013.

Fiegl, Charles. "Medicare's Doctor Records Riddled with Errors."
Amednews, 17 June 2013. Web. 14 July 2013.

Fiegl, Charles. "Medicare Physician Compare Website Undergoes Overhaul." Amednews, 8 June 2013. Web. 14 July 2013.

Rau, Jordan. "Medicare To Tie Doctors' Pay To Quality, Cost Of Care."
Kaiser Health, 15 Apr. 2012. Web. 14 July 2013.



Dylan J. Chadwick


Dylan Chadwick is a graduate of Brigham Young University where he earned a Bachelor of arts in English and a minor in Spanish. Though spending his formative years in Cardiff Wales, he came to adolescence in Elizabethtown Kentucky, and considers it his home. He received the Eagle Scout Award, served a voluntary humanitarian mission to inner-city Los Angeles from 2007 to 2009, and once met Alan Alda on a golf course. He's an avid writer who cut his teeth contributing to student papers and continues writing for various print magazines, blogs and web resources. A ravenous fan of baseball, rock music and Dan Aykroyd-era Saturday Night Live, he plans on one day utilizing these interests in a Masters degree in American Studies and Literature. He also maintains a freelance illustration company on the side.