New CAQH directory lists FHIR endpoints, third-party applications to help with compliance with CMS interoperability rules

With new regulations from the Centers for Medicare and Medicaid Services coming into effect this year and next year affecting information sharing for health plans, the Council for Affordable Quality Healthcare recently unveiled its CAQH Endpoint Directory for help payers comply.

the Directory of CAQH terminals has been developed, with the support of IT provider Edifecs, as a one-stop-shop for FHIR validated payer terminals and third-party applications.

To build it, CAQH convened a working group of member health plans to gather feedback on 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 of Health Information Technology. And it has collaborated with interoperability groups such as HL7 Da Vinci Project and CARIN Alliance.

CAQH has partnered with EHNAC, the standards development group, will soon offer incentives to directory participants to be “accredited to demonstrate their technical, privacy and security credentials to engage in a FHIR API ecosystem,” he says.

The 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 the connections needed to exchange information.

Future versions of the directory may also include vendor endpoints and new services to enable more accurate data matching for payer-to-payer data exchange.

the CMS Final Rules requiring API-enabled data sharing for payers was released in March 2020. Its requirements will place heavy burdens on many health plans unaccustomed to the technological imperatives of interoperability.

To help, the CMS Rules drew on the experience of the Da Vinci Project, which is exploring ways to leverage FHIR to drive data sharing towards the broader goal of value-based care.

Yet, as recently as last August, a majority of health plans said they were still not ready to meet the new FHIR standards of the rules.

“Providing the industry with a single place to find and connect to payer FHIR terminals and third-party applications is essential for interoperability and load reduction,” Robin Thomashauer, president of CAQH, said in a statement.

“The CAQH Endpoint Directory, developed with stakeholders across the healthcare industry, will simplify how organizations connect and support consumers with better access to their healthcare information.

Twitter: @MikeMilliardHITN
Email the author: [email protected]

Healthcare IT News is a HIMSS publication.

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