Gartner Research

Prepare for CMS Interoperability and Patient Access API Compliance for U.S. Healthcare Payers

Summary

CMS mandates that healthcare payers in government programs like Medicare Advantage and managed Medicaid share clinical and claims data with members and member-selected third parties. CIOs must evaluate FHIR API and repository solutions, as well as implement consent management to comply.

Published: 15 June 2020

ID: G00725481

Analyst(s): Mandi Bishop

Table Of Contents

Overview

Introduction

Analysis

Gartner Recommended Reading

Note 1: Regulatory Detail for Data Requirements per Plan Type

Note 2: Links to Relevant Specifications and Implementation Guides

Note 3: USCDI Version 1 Data Classes and Elements

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