The real opportunity of the interoperability mandate is the transformational impact it can have on the way health plans operate their businesses - if they so choose. This requires implementing appropriate security measures consider deploying features like multi-factor authentication, endpoint patching, IP whitelisting and credentialing to ensure PHI remains protected. Health plans must ensure they are meeting these various state requirements while protecting member data from being released to unauthorized entities. Consent rules vary from state to state, and at the end of the day, health plans are responsible to ensure health data is protected no matter where care is provided. Consent for the sharing of health information can be complicated for vendors who operate in multiple states. Deploy an interoperability education plan to help members make the best decisions about where they distribute their personal health data. That doesn’t mean members are guaranteed to make the best decisions about their data members who decide to use or connect to third-party applications need to understand the privacy and security rules of those applications. The interoperability mandate puts control of data in the hands of members, who will be able to access insightful, actionable information that should help them make better decisions about their care. This means making sure your systems can follow data from any digital health application all the way through to a provider visit. Your customer service representatives need a complete view of the member journey in order for them to answer any questions your members may have. At the end of the day, interoperability is about member experience. You need a partner that can keep up with the HL7 FHIR implementation guidelines to ensure that data can be shared with third-party applications. The requirements of the mandate have already changed and are bound to change again. If you’re building a system to comply with the interoperability mandate, you’re creating your own impediments to success. Your interoperability solution must go beyond installing a FHIR-compliant server.
Partners should understand the importance of getting the right information to the right people at the right time. Select partners with deep expertise in healthcare and technology in order to avoid privacy and compliance roadblocks down the road and to ensure your system is privy to the complexities of healthcare. Here’s what health plans and their CIOs can do to ensure they’re on the right path forward. The mandate itself is a starting point for creating a healthcare system that helps members better manage their health, helps providers deliver higher quality care, and encourages innovations in digital health that will deliver better outcomes and an improved healthcare experience.Ībacus Insights is here to help health plans go beyond compliance and venture into the future of interoperability. The truth is health plans should be doing more than complying with the interoperability mandate. We’ve learned from the price transparency rule that compliance can be tricky, and with the interoperability mandate, there are sure to be even harsher realities coming down the pike - especially if plans run afoul of state laws regarding HIPAA and consent management. Health plans across the country are already beginning to feel the impact of CMS’ Interoperability and Patient Access Final Rule. There are also a bevy of implications for plans if they fail to comply with the mandate. The implementation of this long-awaited mandate, which will allow patients to request and have access to their medical data to share with plans, providers, and digital applications, represents a new horizon for health plans, rife with opportunity for innovation.
It’s been over a year of anticipation, but the Centers for Medicare and Medicaid’s Interoperability and Patient Access Final Rule is finally coming into effect.
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