NextGate Responds to CMS on CY 2020 Physician Fee Schedule Proposed Rule

Leading patient identification solutions provider centers comments on agency’s request for information on patient matching

PASADENA, Calif., September 25, 2019 NextGate, the global leader in enterprise patient identification, today submitted comments to the Centers for Medicare and Medicaid Services (CMS) in response to a request for information on patient matching as part of the proposed changes to the Medicare Physician Fee Schedule for Calendar Year (CY) 2020.

In a letter to CMS Administrator Seema Verma, NextGate praised the agency for supporting the development of patient matching initiatives and engaging with the private sector to facilitate a workable and scalable patient matching strategy as a means to advance interoperability.

In the absence of a unique patient identifier, NextGate pointed to higher quality, match-relevant data elements and effective use of enterprise master patient indexes (EMPIs) as the greatest opportunities to increase patient matching accuracy.

NextGate stated while there is value in CMS advancing more standardized data elements, the matching issue is not primarily driven by a lack of data elements. “Fundamentally, the issue is consistent and accurate capture of the data elements that are available for patient matching, such as more consistent capture of addresses and phone numbers,” the letter stated. “Such consistency is enormously important for EMPIs and other algorithm-based solutions to match at a high rate of accuracy.”

Further, NextGate added that it favors tools focused on data quality, especially those that verify and validate patient addresses. “In our experience, a high-quality patient address, along with the patient’s birthday, are very powerful for accurate algorithm-based patient matching. Adding an accurate phone number provides even more power for the match.”

For over two decades, NextGate has been helping healthcare organizations around the world overcome the clinical, operational and financial challenges that result from duplicate records and disparate systems. Its flagship EMPI solution currently manages patient identities for more than two-thirds of the U.S. population and one-third of the populations in the U.K. and Australia.

A firm believer that accurate patient identification is a prerequisite for interoperability and patient safety, NextGate addressed several key areas for advancing nationwide matching efforts, including:

  • Deterrence of a mandated patient matching algorithm or single software vendor solution.
  • Cautionary use of identity proofing or third-party reference data, including credit or financial information, that does not support matching efforts for minors or immigrants.
  • Considerations for looking beyond EHRs as the owner of patient identity, stating that the core identity of a patient and basic associated demographics should not be in the control of any single system, but rather externalized from such insulated applications to maintain accuracy and consistency across all connected systems within the delivery network.

“We appreciate CMS’ distinct recognition of the value that the private sector brings to advancing patient matching accuracy as a conduit for interoperability, particularly as the federal ban on unique patient identifiers remains,” said NextGate CEO Andy Aroditis. “NextGate has invested more than twenty years in patient identity management and are well-positioned to support the agency’s efforts in enabling a longitudinal health record so that safe, cost-effective, high-quality care is realized.”

The full text of NextGate’s letter to CMS can be found here.

About NextGate
With over 200 customers in four countries, NextGate is the global leader in healthcare enterprise identification. Committed to helping organizations overcome the clinical, operational and financial challenges that result from duplicate records and disparate data, our full suite of identity matching solutions connects the entire healthcare ecosystem to drive critical improvements in quality, efficiency and safety. NextGate’s market-leading EMPI currently manages more than 300 million lives and is deployed by the nation’s most successful healthcare systems and health information exchanges. For more information, visit

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Media Contacts:

Stephanie Fraser
Director of Communications and Media Relations, NextGate
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