Summary
This issue brief presents findings on the readiness of health plans to implement HL7 Fast Healthcare Interoperability Resources (FHIR) in response to the Centers for Medicare & Medicaid Services (CMS) interoperability requirements. The document outlines the stages of HL7 FHIR implementation readiness among medical plans, indicating that 70 percent were in the planning phase for future testing and pilots, while 25 percent had begun conducting production-level data exchanges. The brief details the types of information health plans are planning to exchange using HL7 FHIR, including prior authorization and patient health data. Additionally, it identifies barriers to HL7 FHIR adoption, with 85 percent of plans citing a lack of interest from trading partners as the primary obstacle. The methodology section explains how the data was collected through the 2020 CAQH Index, which focused on health plans' interactions with HL7 FHIR and their readiness to comply with upcoming CMS regulations.
