Payer to Payer Data Exchange
Mandate is January 2022.

It’s time to prepare healthcare services for the 21st century…and beyond.


What is the CMS Interoperability and Patient Access Final Rule?

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For decades, a lack of seamless data exchange between health services agencies detracted from optimal patient services and healthcare cost savings. As part of the MyHealthEData initiative, this final rule will drive interoperability and patient access to health information by streamlining patient data using CMS authority to regulate public health services, like Medicare Advantage (MA), Medicaid, CHIP, Qualified Health Plan (QHP) members, and Federally-facilitated Exchanges (FFE)

The CMS Interoperability and Patient Access Final Rule ensures:

  • Better Patient Access To Health Information
  • Improved Health Outcomes
  • Strategic Coordinated Care
  • Reduced Costs

What Does This Mean for CMS Healthcare Delivery Services?


New federal guidelines payers regulated by CMS must exchange an electronic form of the USCD v1 data set at the patient’s request.

As patients transition between plans throughout their enrollment and request data among payers, care plan members create a data history thus creating a cumulative record as the member moves along plans.

  • But how should payers send this information?
  • What are the end points for successful delivery?
  • How do you standardize the process among payers?
  • Can it be automated?

Simplus can help.

At Simplus we leverage industry trends, industry-specific experiences, and deep Salesforce and Salesforce Industries (formerly Vlocity) knowledge to build innovative solutions. We believe that Salesforce Industries can help accelerate the value that the patients receive through Interoperability. At Simplus we understand that Interoperability is about more than just a patient data point, it’s an opportunity to personalize healthcare even more. With Salesforce Industries, Simplus can help your organization achieve the following:

Coordinated Care

Improved Health Outcomes

Reduced Costs

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