Here’s what ONC’s new “information blocking” rule means for your health plan.

In February, the Office of the National Coordinator for Health Information Technology (the ONC) announced a new proposed rule to prevent “information blocking.” Interoperability has long been a goal of the push for healthcare to adopt electronic systems. While this initiative focuses particularly on patient access to their EHR data, the potential is there for every stakeholder along the healthcare continuum to benefit. As CMS Administrator Seema Verma succinctly put it, “This rule is about insurance companies.”

So, what do these rulings from ONC and HHS mean for your health plan? Why, opportunity of course!

Improve Continuum of Care Relationships

Improving relationships with members and providers is already a focus for health plans, and data sharing is another way to accomplish that goal. As health plans strive to adjust to an ever-changing healthcare climate, a recent study reinforced the need for plans to focus on members’ needs rather than risk management (Deloitte February 2019).


“Consumers are going to drive this shift to new models of care.” (source)


With electronic health records (EHRs) formats mandated to be standard by 2020, health plans can do much to support better access to information. Your health plan’s relationship with members and providers stands to improve from an open-arms approach to technology adoption at your organization. Open sharing of EHRs is the future of data in healthcare, and we think this is a great advantage for health plans.

Comprehensive Data Supports High-Value Activities

With access to more comprehensive data, your health plan is better equipped to tackle value-based care, population health management, cost containment and other initiatives. Predicted health IT trends, like big data and a changing healthcare delivery model, are seeing cultural implications with large-scale disruptors like Amazon entering the scene.

“An advantage these ‘digital natives’ have over established firms is that they’re equipped, both technically and culturally, to effectively harness data in near real-time, transforming it into actionable insights, and to make agile, data-driven decisions. In contrast, analog companies are characterized by decision making that tends to be laborious and informed by incomplete or old data,” says Dr. Ferdinand Velasco, senior vice president and chief health information officer at Texas Health Resources.

Opening up access to information will accelerate innovation at organizations, writes Lucia Savage (former Chief Privacy Officer in the Office of the National Coordinator for Health Information Technology). “The HITECH act is just ten years old, and investments in health IT did indeed unleash economic stimulation of new care delivery modes. ONCs information blocking rule has real potential to accelerate that innovation.”

We’ve Heard This Before

The terms “data sharing” and “interoperability” are not new concepts. Is now the time that they’ll finally take hold? “We need to see this rule as a call to action for the private sector,” says Michael Leavitt, who served as both Secretary of Health and Human Services and Utah Governor.

In other words, this long-awaited ruling is evidence of a true shift in data operations for health plans. “Since Medicare Advantage and Medicare Managed Care health plans are already exchanging claims data with CMS, the proposed rule would simply open access to the patient,” adds FierceHealthcare.  And as Neil Patel says, “You don’t need to respond to every single threat that comes your way. But you need to start looking at trends.” The trend is clear: disrupt or be disrupted.

With that in mind, maybe the bigger question is, are your current systems equipped to receive and share data? If not, put a plan in place today to remedy that situation. End information blocking at your organization.

Talk to ClarisHealth about how Pareo® can transform your health plan’s payment integrity operations.

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