In our recent webinar, “Implications of the Final Rule – Challenges & Opportunities Ahead,” our panel of experts discussed the intricacies of the CMS Interoperability and Prior Authorization final rule, building upon the insights shared in the first part of this series, “Breaking Down the Final Rule: Takeaways & Actions.” The initial webinar provided valuable recommendations for organizations striving to achieve compliance, setting the stage for a comprehensive exploration of the challenges and opportunities presented by the final rule.
Key topics covered included:
Minimizing gaming in Medicare Advantage Plans and the evolution of data sharing:
The panel addressed the ongoing policy debates surrounding Medicare Advantage (MA) plans and associated costs. Notably, the Centers for Medicare & Medicaid Services (CMS) released a request for information, underscoring the importance of minimizing gaming in MA plans. The conversation then shifted to the changing landscape of data sharing in healthcare, emphasizing transparency and information availability. The emergence of Patient Access, Payer-to-Payer, and Provider Access APIs was also explored, offering a positive outlook on increased utilization.
Being proactive with data sharing and understanding Patient Access reporting requirements:
Our experts stressed the proactive use of technologies like APIs, along with the shift from patients having to request their data to a more proactive approach. The panel detailed how patients can leverage their data and how payers can fulfill reporting requirements, simplifying processes for everyone involved.
Balancing sharing data and protecting privacy, new tech guides, and the future of healthcare data exchange:
The discussion examined the delicate balance between sharing health data and maintaining privacy, navigating laws such as HIPAA. Our experts highlighted technology guides that assist in overcoming these challenges, emphasizing the growing significance of Fast Healthcare Interoperability Resources (FHIR®). The panel encouraged collaboration within the healthcare sector for a seamless transition to new technologies.
The journey toward compliance and interoperability is continuous, and this webinar series seeks to offer ongoing guidance and insights. To learn more about the CMS Interoperability and Prior Authorization final rule: