CMS-0057-F Interoperability, Part 2

CMS-0057-F Interoperability for Value-Based Payers

Interoperability and Value-Based Care::
How Payers Can Strengthen Collaboration and Outcomes

Payers have the data. Providers need the data. CMS-0057-F is finally making it possible to close that loop.

The value-based care movement depends on trust and transparency. But all too often, the data that could support that trust—clinical histories, medication adherence, utilization trends—gets lost in disconnected systems.

CMS-0057-F changes that.

With required APIs for patient access, provider directory, and payer-to-payer data exchange, the rule empowers payers to become better partners—not just better processors.

Real-World Example: A leading payer in Florida implemented CMS-compliant APIs and partnered with two major ACOs to exchange claims and encounter data in near real time. The result? 18% faster risk adjustment coding and a 22% improvement in care gap closures during the measurement year.

Here’s the opportunity:

• Proactively support ACOs and providers in managing high-risk populations
• Push real-time data into care coordination platforms for faster, smarter decisions
• Reduce abrasion with automated prior auth and referral workflows

Payers who treat interoperability as an enabler—not just a requirement—can become the backbone of true value-based care delivery.

At AaNeel, we help payers use data to drive collaboration. Our solutions deliver real-time insights into provider workflows—without adding noise.

Next Up in Part 3: Scaling isn’t just about size—it’s about coordination. In the final installment, we’ll explore how interoperability helps payers streamline infrastructure across regions, lines of business, and provider networks.

Attending AHIP 2025?
Join us at Booth #1406 to explore how AaNeel’s Health Access Cards and integrated solutions help payers move beyond compliance and unlock true interoperability. Let’s build a smarter future of connected care—together.

Want more? Download the full CMS Interoperability White Paper and explore how your organization can lead the future of connected care. 📄 Download Now