The U.S. Centers for Medicare & Medicaid Services (CMS) is mulling over the creation of a National Directory of Healthcare Providers and Services (NDH).
Through a recent request for information (RFI), the agency is seeking insight on how a CMS-led directory could reduce the burden on providers and payers by creating a single, centralized system that would promote real-time accuracy for patients.
Creating a directory of certified providers and services could help facilitate better care coordination and transitions of care, reduce some administrative tasks, and support interoperability throughout the health sector, CMS indicated.
“Easy access to accurate and useful provider directory information is critical for patients trying to find health care that best meets their individualized needs and preferences,” said CMS Administrator Chiquita Brooks-LaSure in an announcement. “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.”
The agency’ RFI is open to public comment for a 60-day period that expires on Dec. 6.
CMS is asking the public whether consolidating provider data could help improve access and care decisions by making it easier for patients to identify, compare and locate services that meet their needs and preferences. This could include improving patient awareness and access about the end-of-life care options in and around their regions.
Roughly half (50.7%) of Medicare decedents elected hospice in 2018, reported the National Hospice and Palliative Care Organization (NHPCO). Of these, more than 53% received hospice care for 30 days or less and roughly a quarter were on services for a week or less, according to NHPCO.
Health care directories can serve as an important resource for patients and their families, according to CMS. The current system is “fragmented,” CMS indicated, resulting in patients struggling to find updated provider information in their insurance network and regions.
Current reporting requirements have health care staff entering information across multiple databases, creating redundant and heavy operational burdens, according to the agency. Because of this, “directories often contain inaccurate information, rarely support interoperable data exchange or public health reporting, and are costly to the health care industry,” CMS stated in the announcement.
Providers have increasingly sought ways to lighten workloads and relieve pressures on employees amid widespread workforce shortages. High levels of burnout among staff have led to rising turnover rates in hospice, with the pandemic only exacerbating the problem.
Another potential benefit is improving interoperability for providers and payers.
A CMS-led national directory could directly support network interoperability through a Trusted Exchange Framework and Common Agreement (TEFCA). This could allow payers to seamlessly update their own directories from a single directory through an Application Programming Interface (API), the agency indicated.
Public feedback will aid CMS’ understanding of the current scope of health care directories, as well as inform the agency’s consideration of developing an NDH.
CMS is specifically requesting public feedback on what provider types, entities and data elements should be included in the technical framework of an NDH, along with priorities for a possible phased implementation and any challenges, risks or actions the agency should address in its potential development.
