CMS seeks comment on first healthcare provider directory

CMS is seeking public input on a relatively new concept for the agency: the “National Directory of Healthcare Providers and Services,” which will contain information on healthcare providers and services. A request for information was sent out this week.

The agency’s view is that healthcare directories can potentially serve as an important resource for patients, helping them locate providers who meet their individual needs and preferences and allowing them to compare health plan networks. Directories, CMS said, also have the ability to facilitate care coordination, health information exchange and public health data reporting.

What inspired the move is a growing view from within the federal government that the healthcare directory landscape is fragmented. This, CMS said, results in patients sometimes struggling to find up-to-date information about providers in their network and providers facing redundant and burdensome reporting requirements to multiple databases.

Because of that burden, directories often contain inaccurate information, rarely support interoperable data exchange or public health reporting, and are costly to the healthcare industry, in the feds’ view.

WHAT’S THE IMPACT?

In 2018, CMS added fields to the National Provider and Payer Enumeration System (NPPES), which assigns HIPAA-mandated unique identifiers for healthcare providers, for providers to submit digital contact information. A robust health care directory built on modern interoperable technology, CMS said, could greatly improve the availability of provider data and spur electronic health data exchange.

CMS is seeking public input on a directory that could serve as a “centralized data hub” for all healthcare directory and digital contact information with accurate, up-to-date and validated data in a publicly accessible index, developed through streamlined information submission from providers. CMS is seeking comment on whether consolidating the data could help improve access to care and patient choice by making it easier for patients to identify, compare and locate providers who meet their needs and preferences, such as those related to office accessibility, languages spoken or other data.

The agency is also seeking comment on how a CMS-led directory could reduce the directory maintenance burden on providers and payers by creating a single, centralized system, with the hope of promoting real-time accuracy for patients.

Using modern interoperable technology, CMS contends, would allow payers to update their own directories seamlessly from a single directory through an application programming interface, or API. It could also make data available in a format that would ease the health data exchange between providers and improve public health reporting, a need highlighted by the COVID-19 pandemic. Finally, a CMS-led directory could directly support network interoperability through the Trusted Exchange Framework and Common Agreement (TEFCA), the group said.

Feedback from the RFI is meant to increase CMS’ understanding of the current landscape of healthcare directories, as well as information useful to CMS when considering an NDH. CMS is requesting public feedback on the NDH concept and potential benefits, provider types, entities and data elements that could be included to create value for the healthcare industry, the technical framework for an NDH, and priorities for a possible phased implementation.

The RFI is open for a 60-day public comment period ending December 6.

ON THE RECORD

“Easy access to accurate and useful provider directory information is critical for patients trying to find healthcare that best meets their individualized needs and preferences,” said CMS Administrator Chiquita Brooks-LaSure. “CMS is seeking comment on how a National Directory of Health Care Providers and Services could better serve patients and reduce unnecessary burden placed on providers to maintain dozens of separate directories. We look forward to hearing from our stakeholders on the need for a single source for this information for the entire health sector.”
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