WASHINGTON, Oct. 8, 2020 /PRNewswire/ — CAQH today announced the development of a centralized directory of validated payer FHIR endpoints and third-party applications. This solution will simplify how healthcare organizations and app developers connect with each other to help consumers access and transfer their healthcare information. The directory, developed with support from the technology company Edifecs, will help payers meet new Centers for Medicare and Medicaid Services (CMS) interoperability regulations that become effective in 2021 and 2022.  

“A single trusted directory of payer FHIR endpoints and third-party apps is essential to expand interoperability, reduce burdens and provide consumers greater access to their healthcare information,” said Robin Thomashauer, CAQH President. “For two decades, CAQH has worked with the healthcare industry to develop solutions that address just this kind of challenge, and we’re pleased to help advance this important national initiative.”

Earlier this year, CMS released a final Interoperability and Patient Access rule that requires CMS-regulated plans to enable consumers to access their healthcare information on a third-party app of their choice. Under the rule, consumers must also be able to transfer that information from a previous health plan to their current plan. The CMS rule requires the use of Fast Healthcare Interoperability Resource (FHIR) application programming interfaces (APIs) to share this information between plans and apps. The CMS rule is intended to facilitate better decision-making, care coordination and improved health outcomes.   

Given the number of plans and third-party apps in our healthcare ecosystem, a directory of FHIR endpoints will enable plans and application developers to efficiently find, validate and update the connections needed to exchange information. Today, there are more than 300,000 possible connections, and without a trusted directory, each plan and developer would have to find, catalogue, verify and maintain these endpoint connections on their own.

The Office of the National Coordinator for Health Information Technology (ONC) FHIR at Scale Task Force (FAST) has highlighted the need for an endpoint directory as part of an overarching set of proposed solutions to advance FHIR implementation. A prototype of the CAQH Endpoint Directory that builds on the ONC FAST foundation was presented at a recent HL7 FHIR Connectathon to gather industry feedback to refine the directory. Over the coming months, CAQH will continue to engage industry implementers and experts to launch the solution early in 2021 in time to enable plans to meet CMS requirements.

To learn more about the CAQH Endpoint Directory, visit https://www.caqh.org/solutions/caqh-endpoint-directory.

About CAQH
For more than 20 years, CAQH has created shared initiatives to continuously increase the effectiveness of healthcare business processes to improve healthcare administration in the United States. CAQH technology-enabled solutions, operating rules and research support almost 1,000 health plans, 1.6 million providers, government entities and vendors. Visit www.caqh.org and follow us on Twitter: @caqh.

About Edifecs
Edifecs develops innovative, cost-cutting information technology solutions to transform the global healthcare marketplace. Since 1996, Edifecs technology has helped healthcare providers, insurers, pharmacy benefit management companies and other trading partners trim waste, reduce costs and increase revenues. More than 350 healthcare customers today use Edifecs solutions to simplify and unify financial and clinical transactions. In addition, Edifecs develops transaction interoperability and standards compliance solutions for worldwide customers in non-healthcare industry segments. Edifecs is based in Bellevue, WA, with operations internationally. For more information, please visit www.edifecs.com.

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