With new Centers for Medicare and Medicaid Services regulations impacting information sharing for health plans going into effect this year and next, the Council for Affordable Quality Healthcare recently unveiled its CAQH Endpoint Directory to help payers with compliance.
WHY IT MATTERS
The CAQH Endpoint Directory was developed, with support from IT vendor Edifecs, as a one-stop shop for validated payer FHIR endpoints and third-party applications.
To build it, CAQH convened a work group of member health plans to gather feedback about their needs and capabilities, and drew on technology expertise at connectathons and other IT industry events.
The nonprofit also worked alongside the FHIR at Scale Task Force launched by the Office of the National Coordinator for Health Information Technology. And it collaborated with interoperability groups such as HL7 Da Vinci Project and CARIN Alliance.
CAQH has partnered with EHNAC, the standards development group, will soon provide incentives for directory participants to become “accredited to demonstrate their technical, privacy and security credentials to engage in a FHIR API ecosystem,” it says.
THE LARGER TREND
CAQH notes that there are more than 300,000 possible connections between health plans and third-party apps. The CAQH Endpoint Directory will serve as a hub to help payers and developers more easily identify, verify and maintain connections needed to exchange information.
Future versions of the directory may also include provider endpoints and new services to enable more accurate data matching for payer-to-payer data exchange.
The CMS Final Rule requiring API-enabled data sharing for payers was published in March 2020. Its requirements will require some heavy lifting for many health plans unaccustomed to the technology imperatives of interoperability.
To help, the CMS rules drew upon the experience of the Da Vinci Project, which explores ways to leverage FHIR to boost data sharing in toward the larger goal of value-based care.
Still, as recently as this past August, a majority of health plans said they still weren’t ready to meet the rules’ new FHIR-based standards.
ON THE RECORD
“Providing the industry with one place to find and connect with payer FHIR endpoints and third-party apps is essential for interoperability and burden reduction,” said Robin Thomashauer, President of CAQH, in a statement.
“The CAQH Endpoint Directory, developed with stakeholders from across the healthcare industry, will simplify how organizations connect and support consumers with greater access to their healthcare information.”
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Healthcare IT News is a HIMSS publication.
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