The National Council for Prescription Drug Programs wants its initiative to enumerate physicians and others with prescribing rights to be more specific and detailed than the long-delayed HIPAA component, the National Provider Identifier.
"The data set itself will be more comprehensive than the NPI," says Renee Branson, marketing director for the NCPDP, a Scottsdale, Ariz.-based trade association for drug manufacturers, pharmacies and pharmacy benefits managers.
The not-for-profit data venture, called HCIdea, will create and sell "value added" products and services, charging a fee based on the richness of the information. Branson says extras could include fax numbers, e-mail addresses, practitioner status--whether a provider has retired or died--academic credentials, professional affiliations, certifications and specialties.
NCPDP's "technical partner" for the program, National Health Information Network, a data processor in Fort Worth, Texas, will set up and distribute the database and is fronting the $2 million launch cost in the form of a loan to the NCPDP.
"We hope to be able to recoup that in a very short period of time," says Ben Loy, NHIN senior vice president of industry relations.
According to Philip Scott, NCPDP senior vice president for healthcare relations and development, "We will pay back the loan with revenue generated from the file, and NHIN will get a percentage of revenue and profits."
There is no cost estimate for the second phase of information gathering or ongoing maintenance requirements.
Marketing the core data
NCPDP will own the core database, customer relationships and Web-based interface for HCIdea. It will market the file to its membership, as well as to government agencies, software vendors and other interested parties, Scott says.
Also, Branson says, "We are looking to form reciprocal relationships with data suppliers," offering, for example, to clean up and standardize state medical licensing board databases in exchange for access to the information.
In its 1998 proposed rulemaking, HHS estimated the NPI enumeration effort would cost about $50 per provider--$100 million to catalog 2 million names--plus ongoing maintenance expenses. (The final rule remains unfinished because Congress has not funded work on the NPI since 1999.)
However, William Braithwaite, M.D., who was the senior advisor on health information policy to then-HHS Secretary Donna Shalala, says the $100 million projection was based on "unreasonable assumptions."
Braithwaite, now Washington-based director of healthcare consulting for PricewaterhouseCoopers, says a private-sector organization ought to be able to do it for $5 per provider.
The government's NPI list would be larger, encompassing anyone who provides any type of Medicare-reimburseable service, including nurses, emergency medical technicians and even taxi drivers who transport Medicare patients--up to 2 million names, according to HHS.
NCPDP will "crosswalk" its database with the Centers for Medicare and Medicaid Services, the U.S. Drug Enforcement Administration, state licensing and other enumeration systems to compile demographic and practice location contact information for HCIdea.
"And if the NPI comes down the pike, we'll crosswalk with that, too," Scott says.