Health IT & Interoperability

CMS’ interoperability agenda is moving from compliance infrastructure to operating leverage for VBC: upcoming electronic prior authorization, MA Star Ratings, provider directory, and PBM transparency changes are forcing payers, ACOs, and delegated-risk groups to modernize data exchange, documentation, and workflow automation ahead of 2027–2028 rule impacts. Risk-bearing ACOs are increasingly treating technology enablement—analytics, care gap closure, risk adjustment integrity, and real-time data connectivity—as core strategy rather than back-office support, a shift reinforced by NAACOS/Innovaccer findings tied to CMS’ ACCESS Model and Duke-Margolis’ fieldwork on ACO tech adoption. At the same time, CMS’ Medicaid quality partnership with 37 states signals a broader pivot from process reporting toward outcomes measurement, raising the stakes for population health platforms that can connect clinical, claims, and social-needs data across Medicare and Medicaid VBC contracts (ACO technology strategy