CCN and PAC ID to NPI: Crosswalk between the NPI Registry and Hospital and Group Records

The federal Centers for Medicare and Medicaid Services (CMS) publishes a wide range of information on U.S. hospitals, which all carry the unique identifier, the CCN number (CMS Certification Number)*. On the other hand (which often seems to not know what its counterpart is doing), CMS also publishes the frequently updated NPPES database (National Plan and Provider Enumeration System), commonly known as the NPI Registry, which uses the NPI number (National Provider Identifier) as its unique identifier. While hospitals and other medical organizations will have only one CCN Number, they are required to have at least one NPI number, and they're permitted to have as many as they like (and they do seem to like quite a few). 

And, between these two ID systems, the CCN and the NPI, ne'er the twain shall meet.

CarePrecise has developed a sophisticated system to "roll up" an organization's NPI-numbered records with its CCN number (and with the PAC ID for practice groups, which stands for "PECOS Associate Control ID"). This mighty trick produces some eye-opening data, such as contact names and titles, license information, specializations, market data added by CarePrecise to NPI records, and the ability to crossmatch groups to their members and hospital affiliations, directly from their NPI numbers. It also permits integration across the complete line of CarePrecise provider data packages, and all of the information that CarePrecise collects or creates and then merges to the NPI records.

Currently, these CarePrecise rollups (or "crosswalks" if you prefer) are the only available such thing in a relatively comprehensive dataset. The full rollup of all medical facility NPI numbers is available for hospitals, and a single "priority" NPI number is currently available for practice groups, with a full rollup of all PAC ID-to-NPI linkages in development with a tentative release date in May 2023.

The hospital CCN-to-NPI crosswalk is part of the Authoritative Hospital Database (APD), and the Group PAC ID-to-NPI link is part of the Authoritative Physician Database (APD) and CarePrecise Platinum.

The "rolling up" is made possible by several CarePrecise innovations, starting with the CoLoCode (co-location code) affixed to almost every provider in the 7 million+ record CarePrecise master reference database. To fill in additional linkages, the Placekey is used. Placekey is a unique "point of interest" identifier, also attached to essentially every one of the 7 million+ CarePrecise provider records, which can readily be used to link data between data suppliers for a variety of purposes.

* The CMS Certification Number has replaced the term Medicare Provider Number, Medicare Identification Number or OSCAR Number. The CCN is used to verify Medicare/Medicaid providers for survey and certification, assessment-related activities and communications. Note that CarePrecise includes the old OSCAR Number in its CarePrecise Complete and CarePrecise Advanced/Platinum datasets, if reported by the provider in their NPI record(s) or available through third-parties, but this is a small fraction of records, and the OSCAR numbers have changed, hence the need for a CCN-to-NPI crosswalk.

Physician and Nurse Burnout 2023

Beyond the increased patient loads due to the pandemic, and the increasing number of older Americans, other burnout-igniting factors are significant, if not as easily spotted. Data collection, which relies almost entirely on what clinicians record manually, has doubled in volume in the last decade. The increasing workload has had a dramatic effect on workflow efficiency and accuracy. This has caused both physicians and nurses to experience burnout as they struggle to attend to patient care needs while complying with burdensome regulations.

Many clinicians have had enough, and they're leaving the profession, or taking some time off. This has the effect of causing additional stress in the workplace as duties shift and workloads increase. Stressed administrators, who must deal with the costs and frustrations of staffing open positions, has risen along with frontline burnout. It's a vicious circle.

The causes of burnout

Burnout is a state of severe mental, emotional, and physical exhaustion typically experienced by those working in high stress environments. It can manifest itself due to an increase in workload, insufficient pay for workload, long hours and lack of rest or breaks, taking on an unmanageable patient load, or excessive amounts of mandated paperwork. All these factors can lead to feelings of extreme fatigue, cynicism about the job and its outcomes, and difficulty concentrating on tasks. If left unchecked and unaddressed, burnout can worsen over time and lead to depression or other health issues. Identifying the underlying causes behind burnout is essential in order to find ways of resolving them and reducing the negative externalities associated with this phenomenon.

The effects of burnout on patients and healthcare providers

Burnout among healthcare providers has a cascading effect on patients, leading to missed diagnoses or inadequate care. This is especially relevant in today’s world, where there is often a lack of physicians and significant nurse shortages. These issues can further compound patients’ suffering since they lead to long waits in waiting rooms with longer wait times for appointments. Burnout presents physical and psychological signs that require attention from both patients and healthcare providers; however, without sufficient numbers of providers and funding, burnout will continue to be a problem for the foreseeable future.

Steps that can be taken to prevent or reduce burnout

It's important for medical organizations to recognize these issues and take steps to reduce demands on frontline workers. Ultimately, we must find new ways to strike balance between improved workloads, accurate data usage, and the safety of patients.

To combat the effects of burnout, companies should take proactive measures to reduce stress among employees. Improved workflow can help by ensuring that processes are efficient and simple, so employees don't have to complete unnecessary tasks. Better equipment, such as faster computers with a quick response time can help employees work faster and with more confidence.

If a shorter work week is possible, consider allowing workers to come in for fewer hours, giving them a break from the hectic day-to-day schedule and allowing them to spend more time on leisure activities that can help to reduce overall stress levels. Finally, providing regular breaks throughout the day also helps reset focus and boost energy levels.

Staff up! Medical staffing is an art best practiced with the help of professional staffing companies, and offloading this part of the work can relieve some of the pressure on administrators, who keep their frontline staff informed about the staffing effort. This communication can relieve some of the concerns that the bosses aren't listening.

Coping with the burnout you feel right now

When you're already feeling the toll of burnout, it can be hard to take a step back. Self-care should be the first priority when it comes to handling burnout. Start by talking to your co-workers about how they are dealing with their workloads. Do not hesitate to ask for help and take some extra time for yourself during the day. Schedule some activities outside of work that allow you to re-energize and connect with others like social events or exercise classes. If possible, formally demand better equipment and systems so that everyone can manage their workloads more easily without sacrificing their well-being in the process. Self-care is essential when it comes to coping with burnout before it takes an even stronger hold on your life and job performance.

CarePrecise is interested in hearing from companies whose products or services can help alleviate burnout in the medical profession. Please contact us!

References

• Zhang, J., Grobler, L., & Saayman, A. (2017). Burnout: An Occupational Hazard in the Health Care Sector? Frontiers in Psychology, 8.

• Yirmiya-Rimmerman, N., & Yerushalmi Bar-Lavie, E. (2018). Conditions for preventing burnout among healthcare workers. International Journal of Nursing Studies, 84, 40-50.

• Harrison, C., Lobo, M., & Lambert, T. (2018). Staffing Strategies to Reduce Burnout and Increase Job Satisfaction among Healthcare Professionals: A Review of the Literature. Administration and Policy in Mental Health and Mental Health Services Research, 45(6), 867–876.

• Gill, T., Lippel, K., & Gallagher, D. (2018). Work-Life Balance for Healthcare Professionals: A Systematic Review and Meta-Analysis of Interventions for Burnout Prevention. International Journal of Environmental Research and Public Health, 15(3), 466.

• Nasrin Shokrpour, Leila Bazrafkan,1 and Marzieh Talebi (2021) The relationship between empowerment and job burnout in auxiliary health workers in 2019.

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.

Two New Beta Provider Data Releases

This summer has seen one spectacular new release of healthcare provider data from CarePrecise already, and a second is on the way. The first one, released just a week ago, is already finding its way into EMR pre-population, new web apps, OpenPayments and HIE applications.

The Extended Professional, Group & Hospital(TM) dataset extends CarePrecise's flagship master database, CarePrecise Access Complete (CPAC), with verified group practice data for physicians and other providers, their hospital affiliations, medical schools and graduation years. The EPGH's Extended Hospital table provides an unduplicated list of all U.S. acute care, VA, children's and critical access hospitals that bill Medicare (essentially all of these hospital types bill Medicare, so this list is nearly complete; link it to hospital data in the CPAC, and you've got everything -- a more complete, up-to-date and verified database of physicians than the American Medical Association's list at a small fraction of the cost... plus more than 3 million other healthcare providers not included in the AMA data.

The EPGH has only been released in beta so far, and in beta it is being distributed to all current CPAC subscribers free of charge through September 2013. The EPGH/CPAC bundle is the only commercially available merged database of NPPES, LEIE, PECOS, PhysicianCompare and HospitalCompare data, and it contains all of the "hooks" necessary to link to CMS hospital quality data and forthcoming physician quality data.

Coming next is the beta release of CP ProCase(TM), a proper-case version of the name, mailing address and practice address in CPAC, for all approximately 4 million records. Using CPAC data for marketing and other communications will be easier and more professional looking. As with the EPGH dataset, the ProCase add-on will be available bundled with CPAC, and not separately.

Planned beta release of CP ProCase will coincide with the August 2013 CPAC update release. As with EPGH, ProCase will be distributed as a free beta for evaluation to all current CPAC subscribers. (Betas are not available on single download purchasers.)

And, as if that weren't enough, our popular software, CP ListMaker, is undergoing a rebuild to add EPGH functionality. (Proper casing is already a feature of CP ListMaker.) The new version -- 4.01 -- will sport new output queries that include the new extended data linked to list outputs, completely configurable to use the new information. Release date for CP ListMaker v4.01 is scheduled to coincide with the August CPAC data release.

Questions about the new products? Call your CarePrecise sales representative at (877) 782-2294.

Practice Group Data Now Part of CP ListMaker

Jan. 29, 2012 -- CarePrecise announces a major upgrade of its  CP ListMaker software that puts all 3.5 million U.S. healthcare provider records – including almost one million physicians – in reach for marketers. Now includes practice group data to help qualify sales leads.

Today we announced a new version of our popular CP ListMaker software, our desktop system that puts all of the 3.5 million healthcare provider records – including approximately one million physicians and tens of thousands of hospitals and ambulatory care facilities – at the fingertips of researchers and marketers. CP ListMaker allows users to pull tightly targeted lists of physicians and other providers based on criteria such as specialty, subspecialty, facility types for organizations, provider gender, wealth/poverty of service area, Medicare enrollment, and many more. The new version, CP ListMaker 3.5, unveils new practice group data, and does it in an interesting way.

Until now, it has been difficult to find data indicating provider’s practice groups. With new data now obtained from Centers for Medicare and Medicaid Services (CMS), combined with CarePrecise’s advanced record linkage system, CP ListMaker identifies practice groups, and can list all of the providers working at each practice location. 

The “Co-location codes” attached to each record make it possible to further qualify potential prospects for companies marketing to the medical community. Not only physician practices, but dental groups, behavioral services groups, and all other HIPAA-covered healthcare providers are co-location coded. The new CP ListMaker offers tools for using the new data. For example, to export a list of obstetric/gynecology group practices of between 3 and 20 members.

CarePrecise’s record correlation processes also make it possible to link providers’ PECOS and LEIE records with their NPI (National Provider Identifier) records ( http://www.careprecise.com/pecos-npi ), providing a rich master record ( http://www.careprecise.com/provider-data-linkage.htm ) that can be used to enrich or update customers’ existing databases. The PECOS data (indicating which providers are enrolled to be able to bill Medicare) has recently been redacted by CMS, now providing only a partial NPI number; however, our system restores the full NPI number. The federal List of Excluded Individuals/Entities (LEIE) database, which lists providers who have been barred from billing federal programs due to fraud convictions or other infractions, also has no unique identifier as distributed; however, CarePrecise links the LEIE data to the NPI data with each monthly update.

With or without a unique identifier, such as an NPI, EIN, UPIN or OSCAR -- or even a telephone number -- the CarePrecise master data management system, known as QoRelate® (http://www.careprecise.com/provider-data-linkage.htm ), can pull provider data together into a master record database from diverse sources. The company offers boutique record linkage services that can be used to merge data acquired during mergers and acquisitions, through cooperatives such as Health Information Exchanges, or from multiple in-house systems.

CP ListMaker is available as part of the CarePrecise Gold bundle, which includes CP ListMaker and the full U.S. healthcare provider database, or separately for customers who already subscribe to the CarePrecise data. The tool runs in Microsoft Access 2003, 2007 and 2010, and is provided open source, making all of the Access tools available to users.

RESOURCES:

CP ListMaker healthcare provider research and market targeting tools:
http://www.careprecise.com/cplistmaker

 

QoRelateMaster Data Management & Record-Linkage:
http://www.careprecise.com/provider-data-linkage.htm  

CarePrecise Gold (complete U.S. healthcare provider database with marketing and research tools):
http://www.careprecise.com/gold

 

Contact CarePrecise:
http://www.careprecise.com/contact