CMS Seeks Input on National Directory of Healthcare Providers

CMS is looking for stakeholder feedback on establishing the first, national directory of healthcare providers and services, according to an unpublished Federal Register notice.

In the request for information (RFI) notice, CMS said the directory would be a “centralized data hub” for directory and digital contact information on healthcare providers across the country. CMS would establish and maintain the national directory and validate the data against primary sources.

The national directory would also be application programming interface (API)-enabled, according to the RFI notice.

“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,” CMS Administrator Chiquita Brooks-LaSure said in an accompanying 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,” Brooks-LaSure continued.

Patients already use provider directories to locate healthcare providers and learn more about the services they offer. However, these directories are typically maintained by individual payers and are not the most accurate aggregation of provider information.

Reporting contact and services data to payers is also a heavy administrative burden for providers, CMS added, citing a 2019 study conducted by the Council for Affordable Quality Healthcare (CAQH) that found physician practices collectively spend upwards of $2.7 billion annually on directory maintenance. That equates to about $1000 per month per practice, or one staff member workday per week.

A single streamlined platform for reporting provider directory information would save practices over $4,700 each year, or approximately $1.1 billion in collective annual savings nationally, CAQH reports.

Because of the administrative burden, provider directories “often contain inaccurate information, rarely support interoperable data exchange or public health reporting, and are overall costly to the healthcare industry,” the RFI notice states.

CMS aims to streamline existing data across its system and publish easier-to-use information using interoperable technology in a centralized location. This would not only give patients more accuraute provdier information but also improve health data exchange and care coordination among providers.

A national directory could also improve public health reporting, a major challenge for the healthcare industry during the COVID-19 pandemic.

The question now is how CMS should establish a national directory of healthcare providers and services.

The RFI notice specifically asks for healthcare stakeholder input on the current state of provider directories and the steps CMS could or should take if the agency determines it has the legal authority and funds to establish a national directory.

CMS also posed questions to stakeholders about the potential benefits of a national provider directory, provider types that should go into one, entities and data elements that could be included to provide value to providers and patients, the technical framework, priorities for a possible phased implementation, and potential challenges and risks.

The RFI is open for a 60-day public comment period. The period will end on Dec. 6, 2022.

To read the full RFI notice, click here.