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Blog | Technology

A national provider directory could be in store as CMS sends out a request for information

Blog | Technology

A national provider directory could be in store as CMS sends out a request for information

The RFI poses many questions that will need to be addressed before CMS moves forward with creating a directory.

CMS has sent out a request for information on the feasibility of establishing a government-run national directory of healthcare providers and services as a means to improve care access, reduce clinician burden and support interoperability.

Current directories are fragmented and limited in usefulness, according to CMS. “Directories often contain inaccurate information, rarely support interoperable data exchange or public health reporting, and are overall costly to the healthcare industry.”

The RFI cites Council for Affordable Quality Healthcare data showing that physician practices spend $2.76 billion per year on directory maintenance, equating to almost $1,000 per month per practice. Moving to a single platform could save the average practice $4,746 annually, or $1.1 billion collectively.

A national directory that's developed and maintained by CMS and enabled by an HL7 FHIR application programming interface “could serve as a ‘centralized data hub’ for directory and digital contact information containing the most accurate, up-to-date and validated data in a publicly accessible index,” the RFI states.

Various stakeholders could benefit, according to the RFI. “In addition to helping patients locate providers that meet their individual needs and preferences, a modern healthcare directory should enable healthcare providers, payers and others involved in patient care to identify one another's digital contact information for interoperable electronic data exchange.”

Key considerations

According to CMS, a few of the many issues that would have to be addressed before launching a national provider directory are:

  • The benefits and challenges of integrating data from existing CMS systems (e.g., the National Plan and Provider Enumeration System) into a provider directory, and whether the directory should interact with state and local systems
  • The types of directory data that should be publicly accessible via a consumer-facing CMS website or an API, and which data should be kept inaccessible due to its proprietary nature
  • Ways in which a directory can support health equity by helping underserved populations receive healthcare services
  • Ways in which participation in the directory could be incentivized for healthcare stakeholders
  • Whether the directory should include stakeholders such as allied health professionals, post-acute care providers, dentists and other provider categories

Comments on the RFI can be submitted through Dec. 6 at Regulations.gov.

About the Author

Nick Hut

is a senior editor with HFMA, Downers Grove, Ill. (nhut@hfma.org).

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