For healthcare payers, a strategically planned implementation journey for regulatory mandates encourages data flexibility, democratizes workflow, and enables innovation across the enterprise. Continue building your enterprise infrastructure, tempering the zeal to go at mandates one-at-a-time. Introduction

InterSystems Payer Services

Well-documented payer walls between the "claims side of the house and the care side of the house" are highlighted with prior authorization. A strategy to comply to the final rule issued by the U.S. Centers for Medicare & Medicaid Services suggests that payers should unify organizations and systems around their member longitudinal health record. Introduction

A payer-to-payer API, intended to be used by payers to populate longitudinal health records for their members, is effectively a fifth mandated CMS requirement for payers.

Understanding CMS-0057-F: Advancing Interoperability and Improving Prior Authorization Processes

Adopting strategies beyond ‘checking the box’ of compliance can lead to new approaches in patient care, competitive advantage in the marketplace, and the potential to enable better health outcomes for members.