In this episode, Ashley Basile, Availity Chief Product Officer of Clinical Solutions, discusses one of the most critical advancements shaping the future of healthcare: payer-to-payer data exchange.

The healthcare industry stands at a pivotal moment as it works to address one of its most persistent challenges—seamless data sharing. On January 1, 2027, the Centers for Medicare & Medicaid Services (CMS) will enforce the Payer-to-Payer Data Exchange Final Rule, requiring health plans to implement APIs for sharing critical clinical, claims, and authorization data when members transition between plans.

This rule has the potential to revolutionize how data flows across the healthcare ecosystem, ensuring that patient information follows them, regardless of where they receive care. However, as Ashley explains, it’s not without its hurdles.

In this episode, Ashley delves into the findings from Availity’s groundbreaking Payer-to-Payer Data Exchange Cohort Program. This initiative brings together leading health plans to identify and overcome the hidden challenges of payer-to-payer data exchange.

We discuss strategic approaches to innovation and mental models for devising clear goals and outcomes among diverse stakeholders.

Thoughts? Guest suggestions? Email us at matt.schlossberg@availity.com

This episode of “Availity On-Air” was produced by Availity LLC. Research by SVM Public Relations & Marketing Communications. Our editor is Kevin McDonald. The show’s production team also includes Travis Froehlich & Derrick Nevado.

Additional Reading

• Availity Payer-to-Payer Resource Hub: LINK
• CMS Payer-to-Payer Data Exchange Final Rule | LINK