Interoperability mandates from the Centers for Medicare and Medicaid Services (CMS) have required major investments by health plans in recent years and will continue to be critical in informing overall organizational strategies for 2024 and beyond. The looming deadlines of CMS-0057-F, the Interoperability and Prior Authorization Final Rule, will have an impact on both objectives and resources.Â
Â
At the HIMSS Global Health Conference & Exhibition in March 2024, InterSystems brought together subject-matter experts with diverse perspectives to weigh in on strategies to meet federal regulatory mandates. One of those experts was Dominick Bizzarro, Chief Strategy Officer, MVP Health Care and Executive Advisor at Innovators Within.
Â
Bizzarro recommends employing the concepts of Agile Development to the strategic planning process, recognizing that no matter how well researched and deeply informed a 5–10-year strategic plan may be, the reality on the ground will never match what was planned for. An agile approach lets an organization set its overall direction, informed by a variety of factors, including regulatory trends, and then iterate and adjust continuously in the context of an overall vision.
Â
Five Key Considerations to Harness Innovation through Regulation
Â
When faced with new regulations and timelines, Bizzarro recommends approaching implementation and compliance from an innovation mindset, and thinking through five key questions:
- Does this align with our why?
Your why is the purpose of your organization and what you’re trying to achieve. Do these regulations align with your why? For payers, compliance can lead to expanded data access and modernized systems that can improve and amplify your efforts.
 - Is it inevitable?
Are some requirements really just a matter of time? If you are reasonably certain that future regulations or expansions are likely to happen, it may be wise to get ahead of those timelines and build comprehensive approaches. If you…
Read the full article here
