For far too long, e-health information is stuck in silos and inaccessible for consumers. With Value Based Care, CMS is pushing towards a patient centric model involving patients in their own care. This has motivated ONC release rules to promote e-HI sharing, increase patient access of their e-HI, & restrict information blocking. If a patient requests their record, and it’s not given electronically and for free, that will be considered Information Blocking.
The regulations of the past, came with incentives for proactive payers. The new Interoperability and information blocking final rule comes with a clear message containing heady warnings of penalties instead.
Payer business challenges
Will require all the affected plans to implement & monitor FHIR-based APIs to make health information (including claims) available to patients
API access to
Plans are expected to make ‘provider directory data’ available to patients (using APIs) within 30 days after changes to the provider directory are made
The required recipe!
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