Again: Call for CMS to Release Tax Numbers

It's 2022 and still CMS fails to include healthcare organizations' tax numbers. Whether you call them TIN or EIN the numbers are not sensitive in any way, and the Centers for Medicare and Medicaid Services should release them. This is a repost of an article from 2010, more than 3 years after the first NPI Registry data was made public - except, of course, for those tax numbers:

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The NPI Final Rule called for CMS to establish a system that would assign a National Provider Identifier (NPI) number to essentially every healthcare provider in the U.S. (HIPAA "covered entities"): now more than 3 million providers and growing. Great. But it was years before CMS released that data for the industry to use. CarePrecise personnel were at the forefront even back then, calling for CMS to release the data. If necessary, we were ready to fight for it, filing our own request under the Freedom of Information Act (FOIA). Federal agencies can't keep such kinds of data from the public. It's the law. CMS eventually looked at FOIA, and at their provider data, and decided that, sure enough, they were going to have to release it. We and our clients were ecstatic; now the industry would be able to produce the complex crosswalks necessary to actually achieve the efficiencies promised by the Final Rule.

Hurray... except CMS decided not to release one of the most useful data points of all. A provider's federal tax number is hardly a private number. Businesses have to give their tax number on every imaginable type of transaction. Employees see the employer's number on their W-2s. CMS's excuse was that sole proprietors and pretty much all individual practitioners would have to give their Social Security Number, or that busy doctors might type in the SSN in the wrong spot. Fair enough, but, as everyone who works with data knows, it's a piece of cake to parse a tax number field to determine if the number is a SSN or a business tax number. In fact, that's just exactly what CMS does in the Other ID fields of the NPPES (National Plan and Provider Enumeration System) database, replacing 000-00-0000 with a string of equals signs.

Instead of just redacting the SSNs, CMS decided it was best just to wipe clean the complete Employer Identification Number (EIN) field -- just in case some uppity docs got... uppity. Many of us have been hoping that CMS would revisit the issue of this gaping hole in the provider data, but it seems that the issue is to be ignored so that it will just go away.

So, here we are, once again, years into it, asking CMS to release non-SSN tax numbers/EINs so that we -- health systems and health plans large and small, clearinghouses, HIT vendors, medical billing and coding vendors -- can make this data do what it was intended to do for healthcare and for the taxpayers.

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Check out the NPI information at CarePrecise.

Healthcare Market Opportunities

The global healthcare market is growing at an unprecedented rate. Over the past decade, advances in technology and medical treatments have revolutionized the industry, allowing for the development of new treatments, therapies, and technologies. As a result, the global healthcare market is expected to grow to a staggering $4.95 trillion by 2026.

Growth Factors

This growth can be attributed to several factors, including increased access to healthcare services in emerging markets and an increasing focus on preventive care. In addition, advancements in digital health technology are also contributing to this growth, as they make it easier for providers to monitor patient data remotely and quickly respond to changes in their conditions or develop treatments that are tailored specifically to them.

Future Expansion

These developments will likely lead to further market expansion in the coming years. To capitalize on this opportunity, stakeholders must ensure that they are actively participating in innovation and leveraging existing trends such as artificial intelligence (AI) integration and big data analytics. As the U.S. population ages, needing more healthcare services, strong market opportunities are emerging for innovative companies, from creating "find a medical service" apps, to caregiver management and inter-organizational information exchange.

Leveraging Opportunities

Of course, companies need to continue investing in research and development efforts related to precision medicine, predictive diagnostics and personalized therapies that can provide better outcomes for patients while simultaneously driving industry growth. But at the same time, consumer-facing technologies, such as patient portals and "find a provider" services need to acquire and deploy accurate healthcare provider information, covering many tens of millions of rows of provider data that is updated constantly.

Companies that sell advanced products to hospitals, physician offices, clinics and other businesses also need provider information to infuse their campaigns with contact information and business intelligence. The U.S. healthcare industry is aggressively competitive, and business intelligence is jealously guarded. The job of finding the information is challenging, and companies like CarePrecise are dedicated to just that task.

Conclusion

To be successful, it is essential to have a comprehensive understanding of the market dynamics and leverage existing trends such as AI integration and big data analytics. Equally important is having accurate healthcare provider information - which can be effectively provided by companies like CarePrecise. Using these resources, businesses will be able to reach out to healthcare decision makers with their messages.

By engaging with these strategies now, stakeholders will be able to take full advantage of the rapidly expanding healthcare market – which is set to become one of the most lucrative industries of our time.

Physician Quality Grading for Consumers

Update March 2023: Physician Compare data is available as part of a rich physician database compiled from Physician Compare and numerous other sources. All reported physician/facility affiliations are included, with more than 50,000 medical facilities covered. 

Columbia University Medical Center has just this week [week of 4/12/2016] published a guide to the Physician Compare quality data. While the release of physician quality data has been delayed, expectations are that it will appear in 2017.

CMS will generate star ratings based on data drawn from the Consumer Assessment of Healthcare Providers and Systems (CAHPS), the Physician Quality Reporting System (PQRS), as well as Accountable Care Organization (ACO) and claims data. CMS will set benchmarks based on the Achievable Benchmark of Care (ABC) methodology.

The data will be made available with the intent to help consumers to make informed decisions and to encourage physicians to improve performance, leading to more efficient and healthful outcomes.

CarePrecise will continue to monitor the project, and will begin including physician quality data in an upcoming product, The Authoritative Physician Database™, as it currently does with its product The Authoritative Hospital database™. CarePrecise is a leading supplier of healthcare provider data used in consumer-facing web and mobile applications, through special licensing arrangements.