The US Center for Medicare and Medicaid Services (CMS) has taken a step forward in advancing the interoperability and authorization process for the US Healthcare industry by advocating the adoption of the United States Core Data for Interoperability (USCDI) standard. This standard provides a set of health data classes and data elements to be included in patient records for sharing within the health information exchange, allowing insurers and providers to share patient data throughout their healthcare journey. As a result, when a patient wants to compare health plans to switch from one insurer to another, the patient can easily review the options available to make an informed choice, assuming the patient has consented to data sharing.
Healthcare insurance companies, who are custodians of information for millions of Americans, are now required to meet the standards set out by CMS. In addition to this, CMS has also implemented price transparency, enabling consumers to compare insurer plans. The CMS directive allows customers to make informed decisions based on the plans offered. Failure to comply with the CMS guidelines comes with a significant penalty to the insurer on a per member per day basis.