16 Sep How Payers Can Meet New CMS and ONC Patient Access API Rules
In April 2020, the Office of the National Coordinator for Health IT (ONC) and the Centers for Medicare & Medicaid Services (CMS) extended the deadline for organizations in the care ecosystem to implement the final phase of the 21st Century Cures Act.
With many of the rules impacting payers going into effect beginning on January 1, 2021, the most urgent deadlines will be for those that offer Medicare Advantage and Managed Medicaid plans.
The most critical element 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), which is an is 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 interoperability of all medical data.
In addition, the IMAT Payer Solution provides payers with the tools to improve STARS ratings, increase HEDIS accuracy, as well as identify and manage risk within populations.
IMAT also delivers functionality that allows payers to push Gaps in Care, as well as healthcare guidance and alerts, to the provider desktop within the EHR workflow.
To learn more about how IMAT can help payers prepare for these interoperability rules, please download our new data sheet, or contact us. In addition, to learn more about our comprehensive health data management technology and services for payers here.
IMAT was also recently named in a refresh of the Gartner report: “U.S. Healthcare Payer CIOs Boost Medicare Advantage Star Ratings Using Engagement Hubs and Insights Report.”