Advancing Interoperability Requires Close Collaboration between Plans and Providers

April 2022
Full report

A fully interoperable healthcare system would allow providers, consumers, and health plans to share and integrate data across medical records and systems. Despite new regulatory requirements, significant amounts of clinical data remain inaccessible or fragmented. Future policy efforts could improve this by emphasizing flexibility and cooperation.

Since the passage of the 21st Century Cures Act (“Cures Act”), there have been increased state and federal efforts to improve healthcare data sharing. A more interoperable healthcare system could reduce duplication and waste, identify and address gaps in care, and empower consumers with their healthcare data.

However, there continues to be significant need for innovation and collaboration, as efficient data sharing may require technology that goes beyond what is mandated in the Cures Act. As a result, Elevance Health is developing tools and approaches to support cooperation across providers, consumers, and other health plans to promote and sustain data sharing.

Topics

  • Interoperability
  • Electronic Health Records (EHR)
  • Admit, discharge, and transfer data
  • Bi-directional EHR integration

Related Public Policy Research

Best Practices in Using Medicare Advantage Encounter Data for Healthcare Research
September 2020
Experts have raised concerns that encounter data, made available by CMS, may not be appropriate for measuring healthcare utilization or making comparisons between MA and traditional Medicare.
Achieving States’ Goals for All-Payer Claims Databases
June 2018
APCDs have value but they also pose challenges with data collection and use, such as privacy concerns, potential disclosure of proprietary data, and unknown validity of the data collected.