Didn’t get to this year’s National Conference on Medicare, Medicaid & Dual Eligibles to hear HealthEdge expert Maggie Brown’s session Interoperability-What’s Coming and What You Need to Do? We’ve got you covered.

Now, more than ever, the need for data-sharing activity among payers, providers, and patients is necessary to enhance care and improve outcomes. Interoperability mandates from the Office of the National Coordinator (ONC) and the Centers for Medicare and Medicaid (CMS) will start going into effect in 2021 and will provide processes and standards around the communication of individuals’ health data.

The CMS Final Rules adopt the ONC mandates and applies them to three key requirements for Medicare Advantage (MA), Medicaid, CHIP, and Qualified Health Plan (QHP) issuers on the Federally-facilitated Exchanges (FFEs). These health plans must implement a secure Patient Access API, Provider Directory API, and in 2022, a Pay-to-Payer Data Exchange.

These mandates will require a significant lift for many health plans and include collaboration across the healthcare ecosystem.

This presentation explores what’s coming with interoperability, changes from the government, and who should do what. Our regulatory expert will provide critical insights into tactical considerations for each key requirement and strategies for leveraging current initiatives and how they will feed into compliance. In this session, you will discover how a more holistic regulatory landscape can lighten the burden of compliance and lead to better health outcomes, reduced risk, enhanced member satisfaction, improved provider-payer relations, and much more.

Download the presentation to learn more, and click here to watch the full webinar.

Maggie Brown
Regulatory Compliance Manager

Maggie Brown has over 30 years of leadership experience in healthcare and insurance marketplace. Maggie transitioned from health plan management roles to implementing core business solutions for numerous health plans around the country. With the enactment of HIPAA, the Balanced Budget Act, and the Medicare Prescription Drug, Improvement and Modernization Act of 2003 she focused on how to ensure a health plan could implement key technology solutions, meeting the needs of their members, while being compliant in a rapidly changing regulatory environment. Maggie has led implementations for government programs at both new and established managed care companies. Maggie holds a Doctor of Religious Arts degree with a major in Pastoral Psychology.



DOWNLOAD