Healthcare consumerism is on the rise and health plan beneficiaries want to receive the highest quality of care at reduced costs. By extending the health data pool to patients, the Final Interoperability and Patient Access Rules issued under the 21st Century Cures Act is attempting to hand over the reins of the care journey to the patients. That way, quality and cost objectives will be fulfilled while accelerating the momentum of the value-based care movement.

CMS extended the deadlines for the Interoperability and Patient Access final rule due to the COVID-19 pandemic. This came as a respite for payers struggling to support the frontline workers and the affected members. However, the need for interoperability has increased like never before. Establishing transparency and streamlining data exchange is imperative to respond to the crisis effectively. Payers need to act fast to achieve interoperability goals. Besides, the enforcement timelines have been delayed to just six months. Implementing the mandates within a year is still challenging.

This whitepaper outlines the mandates for payers and challenges that stand in the way of implementation. It further sheds light on what payers should do to achieve true interoperability and how leveraging a FHIR-enabled Data Activation Platform can meet the compliance requirements fast and improve data exchange processes. Quick compliance will allow healthcare payers to benefit from interoperability sooner as well as reap early adoption advantage.