26 Aug AHIP Guidance for Payers Regarding the Interoperability Rule

CMS and the ONC recently proposed changes to support interoperability to improve patient access to health data. With many payers trying to determine how to update their processes to meet the 2021 deadlines for compliance, AHIP recently published a comprehensive brief to help ensure a smooth transition.

“The final rules include policy changes designed to support the Administration’s MyHealthEData initiative, which is intended to empower patients with access to their health information through whatever device or app they choose with the goal of fostering choice and competition in health care,” the AHIP brief explained.

The most critical element of the new interoperability rules will be providing members with access to their claims and clinical data using new programming interface (API) standards. Payers must also provide public-facing directory services for provider networks and drug formularies.

These new APIs will use Fast Healthcare Interoperability Resources R4 (FHIR), an interoperability standard intended to facilitate the exchange of healthcare information between healthcare providers, patients, caregivers, payers, researchers, and any one else involved in the healthcare ecosystem.

To help meet this need, the IMAT Payer Solution offers Technology and Services that help with the collection, aggregation, analysis, reporting and auditing of clinical, claims and member data.

The brief also points out how payers can expect further rulemaking from CMS in the fall of 2020 to clarify certain parts of the interoperability rule.

Stay tuned for more news and updates about how IMAT can help payers prepare for these interoperability rules. In the meantime, please contact us to learn more about our comprehensive health data management technology and services for payers.