AHIP MCMC Online

Interoperability: What’s Coming and What You Need to Do

Maggie BrownOctober 20, 2020

Now, more than ever, the need for data-sharing activity among payers, providers, and patients is necessary to enhance care and improve outcomes. Interoperability mandates from the Office of the National Coordinator (ONC) and the Centers for Medicare and Medicaid (CMS) will start going into effect in 2021 and will provide processes and standards around the communication of individuals’ health data.

The CMS Final Rules adopt the ONC mandates and applies them to three key requirements for Medicare Advantage (MA), Medicaid, CHIP, and Qualified Health Plan (QHP) issuers on the Federally-facilitated Exchanges (FFEs). These health plans must implement a secure Patient Access API, Provider Directory API, and in 2022, a Pay-to-Payer Data Exchange. These mandates will require a significant lift for many health plans and include collaboration across the healthcare ecosystem.

In this session from AHIP MCMC Online 2020, Regulatory Compliance Manager Maggie Brown explores what’s coming with interoperability, changes from the government, and who should do what. She provides critical insights into tactical considerations for each key requirement and strategies for leveraging current initiatives and how they will feed into compliance. Watch now and discover how a more holistic regulatory landscape can lighten the burden of compliance and lead to better health outcomes, reduced risk, enhanced member satisfaction, improved provider-payer relations, and much more.

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Didn’t get to this year’s National Conference on Medicare, Medicaid & Dual Eligibles to hear HealthEdge expert Maggie Brown’s session Interoperability-What’s Coming and What You Need to Do? We've got you covered. Download the PowerPoint from the presentation to learn more.