Background and Program Overview
Chapter 224 of the Acts of 2012, An Act Improving the Quality of Health Care and Reducing Costs Through Increased Transparency, Efficiency and Innovation directs the Commission to develop and administer a registration program for Provider Organizations, through which those entities subject to the law will submit information on their organizational and operational structure and governance. Provider Organizations registered with the Commission must also report the details of their financial condition and information on market share annually to the Center for Health Information and Analysis (CHIA), pursuant to M.G.L. c. 12C § 9.
These new requirements reflect the changing nature of the healthcare landscape both in Massachusetts and nationally. As care is increasingly provided through large systems and Accountable Care Organizations that are capable of providing comprehensive patient care across the continuum, and in the outpatient setting, there is need for increased insights into these provider organizations.
Taken together, the Commission and CHIA’s new responsibilities – collectively called the Registration of Provider Organizations (RPO) – create the reporting structure necessary to capture ongoing changes in the health care market. RPO, a first-in-the-nation provider database, will increase transparency of provider structure and performance. The Commission’s registration program identifies and describes the make-up of Provider Organizations, and CHIA’s reporting requirements will supply the data about those organizations that policymakers need to assess system-wide performance.
The Commission has engaged with Provider Organizations, CHIA, and additional Massachusetts state government agencies, and other stakeholders to develop the framework for provider registration. In developing the program’s governing regulation and submission materials, the Commission used the following principles to guide its work:
- Provider Organizations are faced with significant new responsibilities under Chapter 224. RPO must offer a streamlined registration process that prioritizes administrative simplification.
- Provider Organizations have existing points of contact with many state agencies. RPO should avoid requesting duplicative data through ongoing coordination (e.g., with CHIA, DOI, DPH).
- RPO must balance the importance of collecting data elements with the potential burden to Provider Organizations.
- The RPO program should phase in the types of information that Provider Organizations must report over time.
The Commission voted to approve and issue regulation 958 CMR 6.00, Registration of Provider Organizations on July 2, 2014, and the regulation is scheduled to take effect July 18, 2014. The regulation implements M.G.L. c. 6D §11 and creates the framework for Provider Organization registration, including applicability, registration and reporting processes, and specifies the type of information that will be collected by the Commission upon registration.
Final Registration of Provider Organization Regulation (958 CMR 6.00)
In the first year of the program, Initial Registration will be split into two phases: Initial Registration: Part 1 and Initial Registration: Part 2. The Commission created this two-part process to give Provider Organizations an opportunity to ask questions about the registration process and terms used in the regulation and the Data Submission Manual (DSM) before completing the full registration requirements.
To complete Initial Registration: Part 1, Provider Organizations will be required to send a high-level overview of their structure to the Commission by email. Provider Organizations will also be given the opportunity to have a one-on-one meeting with Commission staff to discuss the Part 1 requirements and ensure that they are applying the registration framework to their organization correctly. The Commission will review the information received in Part 1 and upload each Provider Organization’s data into a new online application for registration in the online RPO Submission Platform (RSP). In Initial Registration: Part 2, Provider Organizations will log into the RSP and upload their materials directly to their online application.
Successful implementation of the registration program will require ongoing collaboration between the Commission and registering Provider Organizations. The Initial Registration process will prioritize partnership, support, and fluid communication for Provider Organizations.
Initial Registration: Part 1 Timeline Actions Dates DSM: Part 1 Released July 18, 2014 (Estimated) Training Sessions August – September 2014 One-on-one Meetings August – October 1, 2014 Initial Registration: Part 1 Opens October 1, 2014 Initial Registration: Part 1 Closes November 14, 2014 DSM: Part 2 Released Q4, 2014 (Estimated) Initial Registration Part 2 Q1, 2015 (Estimated)