To Share Data With Medicare Advantage, Medicare Must Go Further On Interoperability

Health Affairs June 24, 2022
Oliver Kim, Kirk Anderson, David Dodge

Interoperability—which the federal government has defined as “the ability of two or more systems to exchange and use the information once it is received”—is critical to making our health care system more efficient and seamless for patients and consumers.

Imagine a system where prior authorization is handled between payers and providers without delay for the patient or where a consumer can get information about the cost of a procedure or a prescription and where to get it by tapping a smartphone. Similar transactions take place every day in many other sectors, but for years we have struggled to consistently enable this information portability in health care.

While Medicare has spurred the evolution of data exchange, Medicare fee-for-service is currently not...

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