Considering Covid-19, one of the biggest obstacles for complying with CMS interoperability requirements for healthcare, is the timeline for implementation. Organizations must develop respective APIs for online claim information and provider directories by the top of the year; by 2022 they have to support patient’s interchanging health info between insurers.
So if you’re a payer, provider, state or federal Medicaid agency, state or federal health exchange, qualified health plan carrier, managed care organization, or Medicare Advantage Plan carrier, you’ve got less than three months to figure this out—especially the API part. Adopting a project management approach for each of these three interoperability phases is critical for meeting these deadlines.
Ideally, you should start by identifying the relevant stakeholders, which fall into one of these three teams:
- technical project management resources,
- governance leadership, and
- line of business.
The governance and business line units should oversee the efforts of the technical project management resource team, which is directly responsible for implementing measures for the three interoperability phases. Although you might have the same people on each team, it’s important to have these three teams for each aforementioned requirement.
For detailed plans on aligning each of these teams, download the full article.
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This is the second part of a three-part series that explores how healthcare organizations can meet the demands of CMS interoperability. You can read part 1 on How to Meet the Demands of the Cures Act as a starting point for the series. And part 3 completes the full series on Why Matching is the Underpinning of CMS Interoperability Requirements.
