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CAQH Seeks Stakeholder Feedback on Provider Data Roadmap

The public comment period for the CAQH provider data roadmap closes at the end of October.

Provider Data

Source: Thinkstock

By Kate Monica

- The Council for Affordable Quality Healthcare (CAQH) has released a draft of its plan to improve provider data accuracy and issued a call for public comment.

CAQH developed the Provider Data Roadmap with Provider Data Action Alliance in order to devise strategies for maintaining data accuracy. The multistakeholder alliance included representatives from provider organizations, health information exchanges (HIEs), health systems, and federal agencies such as ONC and CMS.

Strategies outlined in the roadmap target developing industry-accepted data definitions, improving maintenance processes and accountability measures, centralizing data resources, and fostering greater regulatory alignment.

Additionally, the roadmap addresses the following four core issues with provider data:

  • There are few authoritative provider data sources.
  • Provider data requirements and standards vary widely.
  • Provider data changes frequently and multiple entities must be notified of each change.
  • Providers must be more engaged in the provider data dialogue.

The alliance identified four key principles to guide the development of solutions to these provider data problems.

First, the alliance recommended that providers not bear responsibility for maintaining and collecting their own data. Instead, this task should be delegated to other authoritative sources whenever possible. 

“If providers are asked to directly supply, update, or correct data, they should, in exchange, be given accurate, timely, and complete information on how their data is being used and on any conflicts or problems with their data in the ecosystem,” the roadmap clarified.

The alliance also call for a flexible and adaptable provider data ecosystem. Ideally, the provider data ecosystem would be self-correcting and find ways to normalize or correct problems without expensive or time-consuming outreach to providers, the alliance argued.

“Further, discrepancy corrections made by one stakeholder should propagate to other stakeholders,” they wrote.

Additionally, the alliance suggested solutions to provider data problems must be pragmatic and focused on near-term business realities.

“Even as the ecosystem must be designed to grow and change along with provider data, to be a practical effort with broad industry support, it must address the most pressing business and consumer needs in the short-term, as well appropriately set expectations for data quality,” they wrote.

Specifically, solutions should be low-cost and focused on providing immediate relief.

Finally, the roadmap specified the provider data ecosystem should be industry-governed and standards-based.

The ideal image the alliance envisions for the provider data ecosystem is a not-for-profit governance model that incorporates many viewpoints with a well-defined subset of fundamental provider data elements. Additionally, the ideal ecosystem would be supported by an infrastructure using many architectural approaches and would be flexible to future changes.

 Using these guiding principles, the alliance developed five strategies to improve systematic problems.

“The Alliance agreed that while it is necessary to take a holistic, measured, and methodical approach to beginning to solve the systemic problems in provider data, the pressing needs of many stakeholders require that commitment to action and momentum toward a solution be developed quickly,” the roadmap advised.

According to stakeholders, achieving the roadmap’s goals will require industry-wide commitment and participation; implementation of a governance structure; development of standards; engagement with regulators; and measurement of cost reductions and efficiency across the provider data ecosystem.

The alliance noted that further collaboration via public comment is necessary to achieving its aims.

“The next step in the development of the Roadmap is gathering industry comments to capture diverse perspectives and to produce a document with actionable strategies for working on the problem collaboratively,” they stated.

Stakeholders can submit comments by joining the CAQH webinar with alliance participants on October 18, 2017 from 2:00-3:00 pm (EDT) or submitting feedback through the CAQH online portal.

The comment period will close on October 31, 2017 at 5:00pm (EDT). 

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