The CMS Interoperability and Patient Access final rule (CMS-9115-F) is intended to put patients first by giving them access to their health information when they need it most and in a way they can best use it.

The interoperability rule applies to government regulated health plans including Medicare Advantage (MA), Medicaid, CHIP, and Qualified Health Plan (QHP) issuers on the Federally-facilitated Exchanges (FFEs).

Lack of seamless data exchange in healthcare has negatively impacted patient care which leads to poor health outcomes, and higher costs. The CMS Interoperability and Patient Access final rule establishes policies that break down barriers in the nation’s health system to enable better patient access to their health information, improve interoperability and unleash innovation, while reducing burden on payers and providers.

Patients and their healthcare providers will have the opportunity to be more informed, which can lead to better care and improved patient outcomes, while at the same time reducing burden. In a future where data flows freely and securely between payers, providers, and patients, we can achieve truly coordinated care, improved health outcomes, and reduced costs.