The go-to mechanisms for differential payment – network design, case management, quality measurement and prior authorization – increasingly rely on APIs capable of handling not only claims data but, more importantly, the clinical data critical to intelligent decision-making.
The app store approach in healthcare enables seamless integration of best-of-breed solutions with existing EMR systems, fostering innovation by accelerating the adoption of technologies like AI, telehealth, and remote monitoring.
Greenway Health blends smart technology with human expertise to elevate revenue cycle.
Jill DeGraff, B.well Connected Health’s senior vice president of regulatory, believes the ONC’s new HTI-1 rule is a step in the right direction that will improve data exchange for providers, health tech vendors and patients. She applauded the rule for preserving TEFCA as a voluntary framework and for establishing FHIR-based interoperability as the industry’s de facto standard.
With these APIs, data scientists, developers and analysts can free themselves from frustrating, tedious, and manual efforts to code and clean unstructured data. This is particularly valuable in healthcare where as much as 80% data is locked in unstructured text.
The rule would require payers in the Medicaid, CHIP and QHP programs to build and maintain application programing interfaces to improve data exchange and the prior authorization process. But the rule does not include Medicare Advantage plans, which the American Hospital Association called "disappointing."