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Claims-Based Interoperability

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Policy Examples

  • In 2019 The Centers for Medicare and Medicaid Services (CMS) and the Office of the National Coordinator for Health Information Technology (ONC) issued new rules to promote interoperability. The rules would increase choice and competition while fostering innovation that promotes patient access and control over their health information. source

Outcome Evidence

  • In 2019 the American Medical Group Association (AMGA) reported, for the fourth consecutive year, the most significant external obstacle inhibiting the shift to value based care is a lack of access to administrative claims data. Respondents report that few payers are willing to share administrative claims data, making it challenging to manage large populations of patients to successfully manage risk. source

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