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Health IT & Interoperability

Expert articles and analysis related to health it & interoperability.

200 articlesLast 7 Days

AI Summary — Last 7 Days

Digital quality measurement is accelerating as NCQA moves the HEDIS Transitions of Care measure from hybrid reporting to ECDS and partners with Komodo to use real-world data and AI in future HEDIS measure development—raising the bar for ACOs, Medicaid managed care plans, and MA organizations to capture interoperable clinical data beyond claims (NCQA TRC ECDS update; NCQA-Komodo partnership). At the same time, CMS’s push toward electronic prior authorization and fraud controls—alongside Trump administration action blocking over $1.6B in potentially fraudulent Medicare lab payments—signals a tightening operational environment where VBC participants will need stronger data exchange, documentation integrity, and automated utilization-management workflows to protect revenue and performance.

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