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CMS Publishes RFI for National Healthcare Provider Directory Data Hub

According to a CAQH estimate, transitioning healthcare provider directory data to a single platform could save the healthcare system $1.1 billion annually.

CMS has published a request for information (RFI) on establishing a National Directory of Healthcare Providers & Services (NDH) that could serve as a data hub for healthcare provider, facility, and entity directory information.

Directories that contain aggregated data about healthcare providers and entities can support a variety of use cases, like helping consumers choose a provider, comparing health plan networks, auditing network adequacy, and coordinating care.

However, the fragmentation of current provider directories requires inefficient reporting from providers. Directories often contain inaccurate data, rarely support interoperable data exchange, and are costly to the healthcare industry overall.

According to an estimate from a provider survey completed in 2019 by the Council for Affordable Quality Healthcare (CAQH), physician practices collectively spend $2.76 billion annually on directory maintenance.

The CAQH estimated that transitioning directory data collection to a single streamlined platform could save the average physician practice an estimated $4,746 annually, or an approximated $1.1 billion in collective annual savings across the country.

"We believe that CMS may have an opportunity to alleviate some of these burdens and improve the state of provider directories through a CMS-developed and maintained, Application Programming Interface (API)-enabled, national directory," officials wrote in the RFI.

"An NDH could both streamline existing data across CMS systems and publish information in an easier-to-use format than is available today," they said. "More useful public data could help patients find providers, facilitate interoperable provider data exchange, and help payers improve the accuracy of their own directories."

To align with national data standards, the NDH could leverage standards established by ONC. Specifically, an NDH could use HL7 Fast Healthcare Interoperability Resources (FHIR) APIs to enable data exchange. Systems with different data architectures can use FHIR APIs to exchange health data consistently.

"Through this RFI, we seek input on the current state of healthcare provider directories and steps that we could or should take if CMS concludes that adequate legal authority exists to establish an NDH and proceeds to do so," the officials wrote.

"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, also referred to as digital endpoints for interoperable electronic data exchange," they said.

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