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Policy Ingredients for Real-Time Improvements in Health Care, Prior Auth, and Claims

Healthcare IT Today

Don Rucker, MD, chief strategy officer at 1upHealth , shows us in this video how current regulations and FHIR standards will actually make that happen. In a fast-paced exchanged with John Lynn of Healthcare IT Today, Rucker covers regulations and evolving data exchange standards that foster interoperability and data analytics.

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CMS Releases Proposed Rule Expanding Health Data Interoperability Requirements For Payers

Healthcare IT Today

CMS has released a proposed rule that will require Medicaid managed care plans and other insurers offering products on the ACA Exchanges to support the sharing of patient data amongst themselves.

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Bonus Features – April 28, 2024 – 22% of employers fully trust chronic condition management vendors, Common Agreement v2.0 requires support for FHIR API exchange, plus 29 more stories

Healthcare IT Today

Updates that require support for FHIR-based APIs should allow TEFCA participants to more easily exchange information directly, and enable individuals to more easily access their own information. Clinical data exchange vendor MRO is now automating data exchange between providers for continuity of care purposes.

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CMS Proposes”CMS-0057-P” to Streamline Prior Authorizations with Real-Time Approvals Using Interoperability in Healthcare

Telebehavioral Health Institute

What Is Interoperability in Healthcare? The ability of different systems, devices, and applications to work together and exchange information seamlessly is known as interoperability in healthcare. Medicare and a supplemental plan) to receive care from multiple providers (e.g.,

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Data Quality Scrutiny, SDoH, Value-Based Care…What are the New Healthcare Truths of 2023?

Healthcare IT Today

Many facets of healthcare remained in a state of flux at the close of 2022, as care practices that started during the pandemic found their way into the mainstream, and enthusiasm for new data sources and interoperability outpaced the realities of implementation. We’re excited to see where this goes.

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Prior Authorization Takes a Leap Forward in CMS Regulation

Healthcare IT Today

The Centers for Medicare & Medicaid Services (CMS) have taken a bold step by mandating a standard for prior authorization. A Process in Urgent Need of an Upgrade Clearly, prior authorization is crying out for standardization and interoperability. The release of FHIR in the mid-2010 decade changed everything.

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Bonus Features – February 25, 2024 – 73% of digital health vendors use FHIR APIs, 83% of clinicians think telemedicine is good for chronic condition management, plus 28 more stories

Healthcare IT Today

in January , according to the latest data from Syntellis. A survey published in JAMIA found 73% of digital health vendors are using standards-based FHIR APIs when integrating with EHR systems. Dandelion Health has partnered with The SCAN Foundation to incorporate SDoH data on older adults into its data sets training clinical AI models.

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