Interoperability mandates are coming to health plans. While CMS and state Medicaid agencies have required electronic X12 data transactions for over 20 years, there are new proposed Federal interoperability regulations affecting Medicare Advantage, Medicaid and CHIP MCOs, and Federal Exchange issuers, which come with new requirements for maintaining data sets and digital data-sharing with members. These new requirements include health plan connectivity to a trusted exchange network and making certain data available to members through an open Application Programming Interface (API).
In this webinar you’ll learn about:
- How the FHIR effort and Trusted Exchange Network impose new interoperability requirements on health plans.
- Requirements and timelines for the CMS proposed interoperability rule.
- Types of data a Medicare Advantage, managed Medicaid, CHIP, and Qualified Health Plans on a federally-facilitate exchange will need to push through an open API.
- Key interoperability terms including USCDI, CPCDS, API, and FHIR.
- Requirements for connectivity to a trusted exchange network, including best practice considerations under the ONC’s draft of the Trusted Exchange Network and Common Agreement (TEFCA).
- The role of technology and related use cases to achieve optimized use of data.
- How to compile an interoperability capabilities list to assess readiness.