Ownership Transparency in Healthcare Settings
By Yasmeen Elhaj, Supervisor, Advisory Services
In December 2022, as a result of President Joe Biden’s Executive Order promoting competition and transparency, the U.S. Department of Health and Human Services (HHS) released ownership data for all Medicare-certified hospitals. The data is available on the Centers for Medicare & Medicaid Services’ (CMS) website. This is the first time detailed ownership information is accessible to the public.
The data components include:
- Enrollment information, such as organization name, type, practice location addresses (e.g., off campus), national provider identifier (NPI), and CMS certification number (CCN);
- Detailed information about each owner, such as whether it is an organization or an individual, and whether it is a direct owner or indirect owner (that is, there is at least one subsidiary between it and the provider); and
- A numerical associate ID for each owner to enable a link to the enrollment file.
The availability of this information coincides with the ownership data for skilled nursing facilities (SNFs) enrolled in Medicare CMS that was released in September 2022. That report showed not only the ownership data, but also a methodology for analyzing ownership shares by individuals versus organizations. The ownership data includes approximately 15,000 SNFs.
Facility ownership information benefits consumers by revealing the history of common owners and allows them to analyze market consolidation trends and the correlation between ownership and changing healthcare costs. This allows patients and their families to make informed choices when selecting a healthcare facility.
HHS plans to utilize the ownership data to enact policies designed to expand competition in healthcare, which is a top priority of the Biden-Harris Administration. HHS’s Office of the Assistant Secretary for Planning and Evaluation (ASPE) published the following reports using the data recently released:
- Nursing home market concentration
- Hospital profit margins and mergers
- Nursing home acquisitions and quality
For questions about the information in this article, please contact your Marcum advisor.