CMS Seeking to Create National Directory of Health Care Providers, Services

The Centers for Medicare & Medicaid Services (CMS) on Wednesday released a request for information 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 to patients, payers and other stakeholders.

Specifically, the agency is seeking public input on what a directory of this kind would do for providers and patients. In essence, CMS sees it as a centralized system of provider and patient information that would facilitate care coordination, health information exchange and data reporting efforts.

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In theory, it sounds like exactly what health care experts – both in and outside of home-based care – have been pining for over recent years. Data, reporting and health care information at large remains fragmented, which has resulted in “interoperability” becoming a buzz word.

CMS believes the directory would be of help in its efforts to improve access to care, reduce clinician burden and support that interoperability throughout health care.

“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 a statement. “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.”

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The request-for-information period will be open until Dec. 6, 2022.

“CMS is specifically requesting public feedback on the [directory] concept and potential benefits, provider types, entities and data elements that could be included to create value for the health care industry, the technical framework for a [directory], priorities for a possible phased implementation, and prerequisites and actions CMS should consider taking to address potential challenges and risks,” the CMS release read.

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

Part of what the agency touted in its description of the directory is the enhancements it could make in the provider-payer relationship.

As managed care gets more involved in both home health and home care – and agencies look to get into value-based care through risk-sharing with these plans – data sharing has become a major topic of conversation.

“When we have partners who we trust, that can share data, where we’re thinking longitudinally for a long-term relationship, and we’re willing to work with them, and they’re willing to work with us through the ups and downs. I think that’s the ingredient,” Aetna CMO Dr. Kyu Rhee said earlier this year, referring to the provider-payer relationship.

The CMS directory, in theory, would create a “centralized data hub.” Because data-tracking – and data-sharing, even more so – has been slow developing in home-based care, conveners have often stepped up to be the middlemen between payers and providers.

Those conveners have essentially provided what CMS is suggesting here – the creation of detailed provider networks. In some instances, they’ve done a lot more, too. But home health providers, in particular, have taken issue with how for-profit conveners do business.

A CMS-led directory of data, health information and more could be of use to home-based care providers from a general data-tracking perspective.

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

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