Your Guide to CMS Regulatory Changes for Payers
Article Jul 12, 2023
Interoperability isn’t a new concept for payers, but there is still a long way to go. Thanks to the 21st Century Cures Act and recent regulatory revisions, including TEFCA, the significance of interoperability is steadily increasing. Collaboration on clinical data exchange between payers and providers is still predominantly optional, but payers are recognizing its value. Clinical data exchange helps break down silos, enhances member care, and can help contain healthcare costs.
It is becoming vitally important for payers to invest in interoperability strategies to stay competitive and adhere to regulatory compliance. Until recently, payer organizations have been largely content with just checking the compliance box. However, some payers are beginning to go beyond compliance in targeted areas. These payers are meeting, even exceeding, regulations while using interoperability gains to drive business goals.
To achieve this, payers must identify key business drivers to support investing in interoperability. Here are some ways payers can utilize the resulting data to drive business and build upon their current strategic advantage:
By leveraging their investment in interoperability, payers can carve out a strategic advantage and create better experiences for providers and members. In the evolving world of healthcare data exchange, payers who use their data to improve efficiency and experiences will come out ahead.