Optum Interoperability and Patient Access Services is a comprehensive solution that helps Medicaid agencies comply with the CMS Interoperability and Patient Access rule. The rule requires health care providers to facilitate patient access to their medical data through one common standard, and Optum’s solution achieves this through the use of the Health Level 7® (HL7) Fast Healthcare Interoperability Resources® (FHIR) Release 4.0.1 standard.

The Optum solution allows Medicaid members electronic access to their health data and medical claims through secure, FHIR standards-based APIs, making provider directories available externally, and exchanging patient clinical data between payers at a patient’s request. Optum’s approach is highly flexible and can be customized to meet the unique needs of each state environment.

The Optum solution includes API translation and mapping services, storage in an accessible format, and access management, which is a critical component for security. Identity access control, the ability to delegate who can see the data, and data transfer between entities are all included in the solution.

The implementation of the Optum solution can help to improve the value of modularity and unlock the value of interoperability. The solution can create a canonical data set combining claims/encounters, clinical and formulary data, providing analytic opportunities to improve the insights about operations and Medicaid populations.

Optum is dedicated to delivering high-quality and reliable solutions, with extensive experience in data integration, quality assurance, and health plan and Medicaid operations. Optum assesses the agency’s goals and technical requirements to deliver a customized solution that is right for each agency.

Optum Interoperability and Patient Access Services provides a comprehensive solution that puts patients first and helps Medicaid agencies comply with the CMS Interoperability and Patient Access rule. The solution is highly flexible, customizable, and driven by the agency’s unique needs, making it a reliable and valuable tool for Medicaid agencies looking to improve their operations and the care of their Medicaid populations.

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