The Impact of Blue Button 2.0 Compliance:

Transforming Healthcare Through Data Utilization

Blue Button 2.0, an initiative by the Centers for Medicare & Medicaid Services (CMS) and the Veterans Administration (VA), aims to enhance healthcare transparency by providing patients with access to their comprehensive medical history. With payer compliance, the focus has shifted to leveraging this data to improve patient outcomes and care efficiency.

Leveraging Blue Button 2.0 Data

Enhancing Care Coordination: Payers and providers can now create a complete view of a patient’s medical history using Blue Button 2.0 data. This holistic perspective improves care coordination, reduces redundant procedures, and leads to more informed clinical decisions and better health outcomes.
Improving Risk Assessment: Health insurers use historical data to assess risk profiles more accurately, ensuring patients receive the right level of care and identifying high-risk patients who may benefit from additional management.
Facilitating Preventive Care: Access to detailed patient data helps providers identify gaps in preventive care, such as missed screenings or vaccinations, reducing the need for complex treatments and lowering overall healthcare costs.
Reducing Healthcare Costs: By enhancing care coordination and minimizing unnecessary procedures, Blue Button 2.0 helps reduce healthcare expenses, benefiting both patients and the healthcare system.

Impact on Patient Costs and Outcomes

Utilizing Blue Button 2.0 data has led to:

Reduced Redundant Procedures: Comprehensive medical histories prevent unnecessary tests, saving costs for patients and the healthcare system.
Improved Chronic Disease Management: Better management of chronic conditions reduces complications and long-term healthcare costs.
Enhanced Preventive Care: Timely preventive measures catch potential health issues early, avoiding expensive treatments.

Success in Patient Data Engagement: AaNeel’s Blue Button 2.0 Case Study

AaNeel’s 2023 study on Blue Button 2.0 involved nearly 15,000 patients, with over 700 opting to share their comprehensive health data.

Key Outcomes:

Improved Clinical Decision-Making: Access to detailed health data facilitated better clinical decisions and more effective treatment plans.
Better Chronic Condition Management: Comprehensive data improved management of chronic conditions, reducing hospital readmissions and enhancing patient care.
Cost Savings: The availability of complete patient data led to significant cost savings by reducing redundant tests and procedures.

Patient Engagement and Data Release
Since Blue Button 2.0’s launch, over one million Medicare beneficiaries have shared their medical history with current payers and providers, enhancing healthcare delivery and outcomes. AaNeel’s success in engaging patients has also earned them recognition by KLAS for their innovative solutions in healthcare interoperability.

Key Regulations Impacting Payers in 2024

Price Transparency Regulations: Effective January 1, 2024, health plans must provide cost-sharing estimates for all covered services, promoting transparency and informed healthcare decisions.
Medicare Premiums and Deductibles: Updated premiums and deductibles for 2024 will impact beneficiaries’ costs, influencing how they manage healthcare expenses.
Medicare Drug Price Negotiation Program: This program aims to lower drug costs for beneficiaries, with new negotiated prices released in 2024 and savings starting in 2026.

Moving Forward: The Future of Blue Button 2.0

While Blue Button 2.0 has significantly improved healthcare transparency and outcomes, further patient engagement and data expansion are crucial. As more patients and providers adopt this technology, the benefits will continue to grow, paving the way for a more efficient, patient-centered healthcare system.

Blue Button 2.0 compliance has not only met regulatory requirements but also created new opportunities for enhancing healthcare delivery. By effectively using Blue Button 2.0 data, payers and providers are creating a more informed, coordinated, and efficient healthcare system that benefits everyone involved.

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Summary

Certification Criterion	Description of Capability	Example Description of Capability	Regulation	Costs or Fees Costs or fees that may be required to support the implementation and/or use of the capability -OR- in connection with data generated using the capability.
Electronic Health Information export	170.315 (b)(10)	Enables a user to electronically export health information at individual patient level or for the entire patient population without developer assistance, providing data in computable electronic format with a publicly accessible hyperlink to AaNeel’s export file technical specifications.	This functionality enables a user to extract reporting data without assistance. The reporting data will be based on criteria selected by the user which will allow user to export the data for their entire patient population or will allow the user to drill down to individual patient(s). When user exports the file, a hyperlink to a publicly accessible page is provided at the header of the file export. The hyperlink will allow one to access the technical specifications file for the electronic export file provided in a computable format.	AaNeelCare is licensed to customers as per the terms of the User Agreement; no additional software required to use the capability, all required is included in AaNeelCare.
Clinical quality measures (CQMs) — record and export	§170.315(c)(1)	Enables a user to electronically record all data necessary to calculate Clinical Quality Measures (CQMs) presented for certification.	This functionality enables a user to electronically capture and export all the data necessary to calculate each of the supported Clinical Quality Measures (CQM), including the codification of CQM exceptions and exclusion.	AaNeelCare is licensed to customers as per the terms of the User Agreement; additional software and/or licensing fees may be required to use the capability.
Clinical quality measures (CQMs) — import and calculate	§170.315(c)(2)	Enables users to import a data file formatted in accordance with HL7 QRDA Category I Release 3 or the corresponding version of the Quality Reporting Document Architecture (QRDA) standard for the CMS annual measure update being certified for one or multiple patients in order to perform calculations on the Clinical Quality Measures (CQMs) presented for certification.	This functionality enables a user to electronically import all the captured data needed to calculate each of the supported Clinical Quality Measures (CQM), and to calculate each certified CQM using the Quality Reporting Document Architecture standard.	AaNeelCare is licensed to customers as per the terms of the User Agreement; additional software and/or licensing fees may be required to use the capability.
Clinical quality measures (CQMs) — report	§170.315(c)(3)	Enables a user to electronically create a data file for transmission of Clinical Quality Measures (CQMs) data in accordance with the CMS Quality Reporting Document Architecture (QRDA) standard.	This functionality enables a user to electronically create a data file for transmission of Clinical Quality Measures (CQM) data according to the Quality Reporting Document Architecture standard.	AaNeelCare is licensed to customers as per the terms of the User Agreement; additional software and/or licensing fees may be required to use the capability.
Clinical quality measures (CQMs) — filter	§170.315(c)(4)	Enables users to record the data listed in §170.315 (c)(4)(iii) in accordance with the identified standards where specified.	This functionality enables a user to electronically filter by any combination of the proposed data elements (i.e., by any one data element (e.g., provider type) or a combination of any of the data elements).	AaNeelCare is licensed to customers as per the terms of the User Agreement; no additional software required to use the capability, all required is included in AaNeelCare.
Authentication, access control, authorization	§170.315(d)(1)	Requires user’s unique identifier(s) (e.g., username or number) is/are verified by AaNeelCare as the one claimed prior to receiving access to electronic health information.	Managing authorized and authenticated users access to the My Health EHR	AaNeelCare is licensed to customers as per the terms of the User Agreement; no additional software required to use the capability, all required is included in AaNeelCare.
Auditable events and tamper-resistance	§170.315(d)(2)	AaNeelCare records actions pertaining to electronic health information in accordance with standards when AaNeelCare is in use, changes to user privileges when AaNeelCare is in use, and records the date and time in accordance with requirements.	Governs what the EHR must capture in an audit log	AaNeelCare is licensed to customers as per the terms of the User Agreement; no additional software required to use the capability, all required is included in AaNeelCare.
Audit report(s)	§170.315(d)(3)	Enables a user to create one or more audit reports for a specific time period that includes some or all of the data specified, including changes to user privileges when AaNeelCare is in use, and record the date and time of the action in accordance with requirements, allowing content included in each audit log to be sortable.	Governs what the EHR must be able to report related to audit logs.	AaNeelCare is licensed to customers as per the terms of the User Agreement; no additional software required to use the capability, all required is included in AaNeelCare.
Automatic access time-out	§170.315(d)(5)	Requires AaNeelCare to automatically stop a user’s access to health information after inactivity for a predetermined period.	Requires the EHR to automatically log off a user after a pre-determined time of inactivity	AaNeelCare is licensed to customers as per the terms of the User Agreement; no additional software required to use the capability, all required is included in AaNeelCare.
Encrypt authentication credentials	§170.315(d)(12)	“Requires AaNeelCare to encrypt stored authentication credentials in accordance with standards adopted in §170.210(a)(2). OR The criterion does not require certified health IT to have these capabilities or for health IT developers to implement these capabilities for a specific use case or any use case, just that they attest “yes” or “no” to whether the Health IT Module encrypts authentication credentials.”	Encrypting authentication credentials may include password encryption or cryptographic hashing, which is storing encrypted or cryptographically hashed passwords, respectively (85 FR 25700).	AaNeelCare is licensed to customers as per the terms of the User Agreement; no additional software required to use the capability, all required is included in AaNeelCare.
Multi-factor authentication	§170.315(d)(13)	The criterion does not require certified health IT to have these capabilities or for health IT developers to implement these capabilities for a specific use case or any use case, just to attest “yes” or “no” to whether the Health IT Module supports multi-factor authentication.	“Requires a setting to authenticate users when logging on to the application. The authentication can be configured based on various Multifactor Authentication (MFA) Methods such as Email, SMS, and Mobile Authenticator. The OTP (One-Time Password) can be sent to one or all these methods.	AaNeelCare is licensed to customers as per the terms of the User Agreement; no additional software required to use the capability, all required is included in AaNeelCare.
Quality management system	§170.315(g)(4)	Requires AaNeelCare to identify the specific QMS used that was established by the federal government or a Standards Development Organization (SDO)	Ensures that a quality management system used by the health IT developer	AaNeelCare is licensed to customers as per the terms of the User Agreement; no additional software required to use the capability, all required is included in AaNeelCare.
Accessibility-centered design	§170.315(g)(5)	This certification criterion requires AaNeelCare to identify relevant standards or laws; or, alternatively, permits AaNeelCare to state that its health IT product presented for certification does not meet any accessibility-centered design standards or any accessibility laws.	Ensures that accessibility-centered design principles have been employed by the health IT developer	AaNeelCare is licensed to customers as per the terms of the User Agreement; no additional software required to use the capability, all required is included in AaNeelCare.

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