Last month, the U.S. Department of Health and Human Services (HHS) finalized two rules that give patients safe and secure access to their health data. These new rules increase focus on a value-based healthcare system and give patients the kind of control over their healthcare decisions that allows them to better manage their own care, but some privacy questions will still need to be addressed.

The MyHealthEData Initiative

President Trump’s MyHealthEData initiative allows every American access to their medical records while prioritizing privacy and security.  The initiative promises to put patients in control of their care by granting access to their health information through new smartphone applications. These are the most extensive rules the federal government has ever implemented for healthcare data sharing policies.  The Centers for Medicare & Medicaid Services and The Wall Street Journal go into detail about these unprecedented rules.

Some changes you will see include:

  • New provisions for Health IT developer’s certification requirements
  • Requires EHR to provide clinical data, promoting new business models of care
  • Advances data through the U.S. Core Data for Interoperability (USCDI), improving flow and safeguarding electronic health information
  • Secure application programming interface (API) that assists patients with access and control over their own electronic health information
  • The ability for patients to acquire and utilize their electronic health information through an app on their smartphone easily and securely

The Effect on Medicare and Medicaid

Starting January 1, 2021, health plans with Medicare Advantage, Medicaid, CHIP, and Federal Exchanges will have requirements to electronically share claims data and other health information with patients in a safe, secure, user-friendly format through API.

To date there are 55 organizations testing these applications.  The Centers for Medicare & Medicaid Services (CMS) were the first to take this step when they launched Medicare Blue Button 2.0 for Medicare beneficiaries in 2018.  From an application on their smartphone, patients can take their health information with them if they change plans or providers throughout healthcare organizations.

Participating Medicare and Medicaid hospitals will be required to send electronic notifications to other healthcare facilities, community providers, and/or practitioners when a patient has been admitted, discharged, or transferred.  These notifications will help providers and practitioners facilitate improved patient outreach and care coordination.

Beginning April 1, 2021, CMS will require states to send daily data for beneficiaries enrolled in Medicare and Medicaid, ensuring beneficiaries are receiving the correct services and accurate billing, alleviating past administrative burdens.

These two finalized rules implemented by the U.S. Department of Health and Human Services will change the future of healthcare for the everyday American.