Interoperability & Patient Access Rule

On May 1, 2020, the Department of Health and Human Services (HHS), through the Centers for Medicare & Medicaid Services (CMS) and the Office of the National Coordinator for Health Information Technology (ONC), issued a rule to improve secure, authorized access to health and insurance data.

Sharing of this information empowers our members with access to their health and insurance information through whatever device or app they choose, allowing caregivers and insurance carriers to work together to best serve our member’s healthcare needs.

Connecting multiple health record sources
In spite of advances in health care technology, including electronic records, there is not an easy or readily available process to connect multiple health care organizations (i.e. doctors, hospitals, clinics, health insurers, and pharmacies.) These new measures will open doors for options to enable health information systems to work together to deliver health care information for patients that can help ensure effective delivery of the best and most affordable care.

Improving health care
5 key benefits of achieving interoperability (Becker’s Health IT) include:

  • Improved care coordination and patient experiences
  • Greater patient safety
  • Stronger privacy and security for patients 
  • Higher productivity and reduced healthcare costs
  • More accurate public health data

How Sanford Health Plan is collaborating for interoperability
Sanford Health Plan has been working to ensure the links and required data, or application-programming interfaces (API) are available to application developers who create apps to support this effort for members. Watch for more information in the future on these new options, and how they can benefit you as a Sanford Health Plan member.

Beneficiary Education Notice

Interoperability links to Sanford Health Plan data

  • Provider directory – connect to find in-network health care providers
  • Member access – secure sharing of claims and health information maintained by Sanford Health Plan   
  • Medicare Advantage Formulary API – list of prescription drugs covered under Sanford Health Plan's Medicare Advantage plans