CMS seeks to create a national directory of health care providers, services

The Centers for Medicare & Medicaid Services (CMS) released a request for information on Wednesday regarding the creation of a “national directory of health care providers and services.”

The effort — a major undertaking — could eventually lead to a new database that better connects home health agencies with patients, payers and other stakeholders.

Specifically, the agency is seeking public input on what such a directory would do for providers and patients. Essentially, CMS envisions it as a centralized system of information for providers and patients that would facilitate care coordination, health information exchange, and data reporting efforts.

In theory, it sounds like exactly what health experts—both inside and outside of home care—have been yearning for in recent years. Healthcare data, reports and information in general remain fragmented, which has led to “interoperability” becoming a buzzword.

CMS believes the directory would be helpful in its efforts to improve access to care, reduce clinician burden, and support this interoperability across health care.

“Easy access to accurate and useful provider directory information is critical for patients trying to find health care that best meets their individual needs and preferences,” CMS Administrator Chiquita Brooks-LaSure said in a statement . “CMS seeks comment on how a National Directory of Health Care Providers and Services could better serve patients and reduce the unnecessary burden on providers of maintaining dozens of separate directories.”

The period for requesting information will be open until December 6, 2022.

“CMS specifically requests public feedback on [directory] concept and potential benefits, provider types, entities and data elements that can be incorporated to create value for the healthcare industry, the technical framework for [directory]priorities for possible phased implementation and prerequisites and actions that CMS should take to address potential challenges and risks,” the CMS release said.

CMS will obviously run the directory. The agency also says the directory will use “modern interoperable” technology that will allow payers to update their own directories from a single directory through an application programming interface (API).

Part of what the agency touts in its directory description is the improvements it can make to provider-payer relationships.

As managed care becomes more active in both home health and home care—and agencies look to enter value-based care by sharing risk with these plans—data sharing has become a major topic of conversation.

“When we have partners that we trust that can share data, where we think long term about long term relationships and are willing to work with them and they are willing to work with us through the ups and downs. I think that’s the ingredient,” Aetna Chief Marketing Officer Dr. Kyu Rhee said earlier this year, referring to the provider-payer relationship.

A CMS directory would in theory create a “centralized data center”. As data tracking – and even more so data sharing – has been slow to evolve in home care, organizers are often stepping up to act as intermediaries between payers and providers.

These organizers have essentially provided what CMS is offering here – the creation of detailed provider networks. In some cases, they have also done much more. But home health providers in particular are taking issue with the way for-profit organizers do business.

A CMS-maintained directory of data, health information, and more can be useful for home care providers from a general data tracking perspective.

It also has the potential to ease the provider-payer relationship—if done right.

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