November 09, 2016
Area(s) of Interest: Commercial Payors Payor Issues and Reimbursement Practice Management
Physicians are reminded that the deadline to review and correct their data for the second cycle of the California Healthcare Performance Initiative System (CHPI) is November 11, 2016. In early September, approximately 13,000 physicians in California received their individual quality measurement scores for the second cycle of the CHPI quality rating program. The program rates physicians using claims data from Medicare fee-for-service, Anthem Blue Cross, Blue Shield of California and United Healthcare. This claims data includes both commercial and self-funded health plan data from HMO, PPO, POS and Medicare Advantage products.
The individual quality measurement scores were based on claims data for patient care provided January 1, 2012, through December 31, 2014. Physicians were assigned a star rating of one to four stars, based on where they fall as a percentile within a “peer group,” for each measure as well as a composite score.
To access the CHPI review and correction portal, physicians will have to register using their username and registration token – both listed at the top left of each page of the report. Once registered, you will receive a confirmation email with instructions to create a password.
According to CHPI, it will treat the data as complete and accurate if no corrections are made. This means that even if a physician has not logged into the online portal during the review and correction period, CHPI will still publish the physician's data.
Physicians who review their data and identify errors have until November 11, 2016, to report any discrepancies via the CHPI online portal. At the close of the physician review and correction period, discrepancies will be evaluated and applied, with the results recalculated prior to the public release of the ratings. After November 11, the review and correction period will close, and physicians will be unable to review the data or report discrepancies.
CHPI has advised the California Medical Association (CMA) that in addition to publishing the ratings publicly, it will also release an aggregated data file to the aforementioned participating plans following the review and correction period later this year. CMA inquired as to how the data would be utilized by the plans, but as of the time of publication, it was not known.
For more information on the CHPI Cycle 2 rating methodology, visit the CHPI website at www.chpis.org. CHPI has also published an FAQ on its rating program and a step-by-step review and corrections tutorial.
Physicians who did not receive a letter but would like to confirm whether they are included in CHPI’s rating results can use the CHPI physician lookup at https://provider.medinsight.milliman.com/clients/CHPI/Public/Lookup.
Physicians who identify a high volume of discrepancies in the data used to calculate their scores are encouraged to contact CMA at (916) 551-2061 or firstname.lastname@example.org.
If you have questions or concerns about the CHPI rating results, you may email email@example.com and they will respond within 48 hours.
CMA recently hosted a webinar where CHPI staff provided an overview of the quality rating project, along with step-by-step instructions on how physicians can review their data for accuracy before the quality scores are published. This webinar is available on-demand in CMA's online resource library and is free to CMA members ($99 for nonmembers).