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InterSystems HealthShare CMS Solution Pack

HealthShare CMS Solution Pack
A Robust Solution to the Interoperability and Patient Access Challenges of CMS Rule 9115
The InterSystems HealthShare CMS Solution Pack™ provides a simplified way to meet the final rule requirements for payers and providers, supporting the rule’s use cases for 2021 and 2022:

For Payers

  • Patient Access APIs – Giving patients access to their own claims, clinical, and pharmacy benefit information (2021)
  • Provider Directory API – Online provider and pharmacy directory access (2021)
  • Payer-to-Payer Data Exchange (2022)

For Providers

  • Admission, Discharge, and Transfer Event Notifications

Use cases for CMS Solutions Pack include:

  • Patient access APIs
  • Claims data mapping
  • Clinical data mapping
  • Pharmacy benefit data
  • Authorization and authentication
  • Identity management
  • Member consent management
  • Event notifications
  • Provider directory APIs

 

CMS Solution Pack also provides a path to address broader use cases using our full InterSystems HealthShare product suite. For payers, InterSystems HealthShare provides the data and analytics required to support use cases such as HEDIS reporting and Risk Adjustment. For providers, use cases include value-based care, population management, and COVID-19 dashboards.

CMS Solutions Pack currently is available for use by customers in the United States only.

Related Product Information

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Matching inpatient and outpatient records with HealthShare Patient Index enabled a single view of patient data, joint ventures with other healthcare organizations, and better information flow.
Modern Healthcare Webinar
Health plans and providers share the common goal of lowering healthcare costs and improving health outcomes—but navigating the path there isn’t always clear due to misaligned incentives and competing priorities. This panel of healthcare industry experts discuss solutions to align financial incentives, improve patient outcomes, bridge the gap in the care continuum and forecast the roadmap to value-based healthcare delivery.
AHIP On-Demand Webinar
Health insurance providers have navigated many changes over the past couple of years, adapting and modernizing their technology stack to comply with a handful of CMS regulations including the Interoperability Rule (9115F), Transparency in Coverage and the No Surprises Act. Concurrently, they are trying to grow their business and increases their margins, all while navigating a global pandemic. Adopting an interoperability strategy and plan is a critical aspect to meeting the numerous challenges and changes that continue to emerge.
A WEDI webinar
In this webinar, WEDI welcomes Alexandra Mugge, Director and Deputy Chief Health Informatics Officer with the CMS Health Informatics and Interoperability Group, to address key elements of the Advancing Interoperability and Improving Prior Authorization Processes proposed rule. Daniel Kalwa, Acting Director, National Standards Group, CMS, joins Mugge to discuss the proposed attachment rule. Viet Nguyen, MD, Chief Standards Implementation Officer with HL7, presents on the FHIR component to the rule and how HL7 plans to support the industry in meeting the 2026 date. Lynda Rowe, InterSystems Senior Advisor, Value-based Markets, walks through some of the proposed rule’s changes to the original interoperability rule (9115-F) and the implications it will have for payers.
Expert Panel Recomendations
As an emergency department nurse in the 1990s, Kimberly Strand and her colleagues knew little about their patients. Healthcare’s reliance on paper records meant it was all but impossible to acquire medical histories and allergies for people who showed up unconscious. The lack of data risked patient health and concerned clinicians.
The Rhodes Group HCV algorithm and communications using InterSystems HealthShare helps New Mexico managed care organizations avoid millions of dollars in penalties for missing HCV treatment targets
A private hospital group in the Middle East is bringing the hospital to patients at home. The care team uses in-home devices to monitor patients and a phone app to deliver device and patient-generated data to its EMR. The physicians and nurses making virtual house calls have all the information they need, using familiar software, for optimal, personalized care.
An Economist Impact Webinar
Mental health experts and industry leaders to discuss the role of AI and digital technology in curbing the mental health crisis. How can patient-centric therapies be designed for better outcomes? How can regulators and educators contribute to digitising mental health care?

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