Big payers, tech, hospitals collaborate on medical claims standards

Some of the largest players in health insurance, technology and clinical care partnered on a new model aimed at making medical claims data easier to access for patients, the companies said July 30.

Under the CARIN Blue Button data model and draft implementation guide, companies like Apple, Anthem, Blue Cross Blue Shield, Google and Pittsburgh-based UPMC agreed to begin testing a common payer consumer data set. Set to go live in 2020, the data model and guide would set standards for sharing claims data with third-party developers in an effort to ease health data exchange.

The data set and model includes 240-plus claims data elements agreed upon by the CARIN Alliance, a nonpartisan group comprising providers, payers, consumers, pharmaceutical companies, consumer platform companies, health IT companies, and consumer advocates. The companies launched the data model and guide at the White House Blue Button Developers Conference in Washington, D.C.

It builds off of Blue Button 2.0, an open application programming interface tool developed by CMS that allows third-party apps and services to connect to and make sense of Medicare claims data.

Below are the 20 organizations that agreed to test the CARIN Blue Button data model and draft implementation guide in 2019:

BlueCross BlueShield of Arkansas
BlueCross BlueShield Association
BlueCross BlueShield of Louisiana
BlueCross BlueShield of North Carolina
BlueCross BlueShield of Tennessee
Blue Shield of California
Cambia Health Solutions / Regence BlueCross BlueShield
Florida Blue
Manifest MedEx
Marshfield Clinic Health System-Security Health Plan
Prominence Health Plan
UPMC Health Plan
State of North Carolina
State of Washington

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