US-based Humana and Providence have launched an initiative to secure and streamline data exchange between healthcare providers and payers, establishing a new standard for interoperability in value-based care.

The collaboration creates a scalable ecosystem for standardised, seamless, and secure data sharing.

Utilising national HL7 Fast Healthcare Interoperability Resources (FHIR) standards,  modern APIs and Da Vinci Project Implementation Guides, the initiative provides clinicians with timely insights whilst protecting patient privacy and reducing administrative complexity.

Humana Insurance president George Renaudin said: “True interoperability should serve clinicians, patients and payers. Together with Providence, we're enabling providers to deliver more effective care and helping our members spend less time on paperwork and more time on their health.”

The initiative is in accordance with forthcoming federal regulations, notably the Centers for Medicare and Medicaid Services Interoperability and Patient Access Rule (CMS-0057), which mandates that organisations offer standardised and secure access to health data.

Both organisations acknowledged the significance of interoperability and have developed the requisite infrastructure to deliver tangible benefits while aligning with federal priorities.

Providence health informatics population vice-president Michael Westover said: “The healthcare industry is overwhelmed by fragmented, inconsistent data formats that make care coordination costly and slow.

“Because we want to be successful in value-based care contracts, Humana and Providence are building a shared foundation of administrative, financial and clinical data using national standards and modern technology.”

The initial phase involves the automated attribution of members for Humana Medicare Advantage. This functionality allows providers to swiftly identify the patients they are responsible for, thereby enhancing care coordination and eliminating manual processes.

Subsequent phases will broaden data exchange capabilities, aiming to lessen administrative burdens and improve clinical decision-making.

The companies anticipate their framework to serve as a scalable model for industry-wide transformation.