CMS Considering Blue Button 2.0 Mandate for Medicare Advantage

CMS Considering Blue Button 2.0 Mandate for Medicare Advantage

The Centers for Medicare and Medicaid Services (CMS) is encouraging health insurers to use data release platforms for enrollees that either “meet or exceed the capabilities of CMS’s Blue Button 2.0,” according to an announcement from the agency on 2019 capitation rates and payment policies.

This encouragement points to a potential future requirement, as the announcement goes on to state that “CMS is contemplating future rulemaking in this area to require the adoption of such [Blue Button 2.0 compatible] platforms by Medicare Advantage plans by CY 2020.”

CMS Administrator Seema Verma spoke to the benefits of adopting such data release platforms in a tweet on April 3:

A requirement might be what’s needed before insurers adopt platforms compatible with Blue Button 2.0. “I will tell you that when we’ve had conversations with insurance executives, they’ve said ‘You need to force us to do this.’ They’ve said that explicitly,” Verma said, according to an article in FierceHealthcare. The article also stated that health data portability has been working its way up the list of agency priorities for Verma.


Sarah Sheber is assistant editor/web editor at the Journal of AHIMA.