From Interoperability to Intelligence: A Conversation with NCQA and Payer Leaders on Clinical Data, Quality, and Payer Performance
Onyx recently convened leaders from across Blue plans, commercial plans, DSNP organizations, and state Medicaid agencies for our inaugural Customer Advisory Forum focused on a question that is becoming more urgent across the payer market: now that more clinical data is finally accessible, what will separate organizations that simply have data from those that turn it into performance? For years, the industry conversation […]
Completing the Chain of Trust for CMS-Aligned Networks
How HL7 Da Vinci and FAST Security work together to support scalable payer interoperability By Mark Scrimshire, Onyx Chief Interoperability Officer CMS-Aligned Networks Raise the Bar As CMS accelerates its Health Technology Ecosystem and the vision for CMS-Aligned Networks continues to take shape, the interoperability conversation is shifting. The question is no longer simply whether organizations can expose APIs. […]
Why Mortality Data Still Breaks Healthcare Operations, and How APIs Can Fix It
By Mark Scrimshire, Chief Interoperability Officer, Onyx One of the most important signals in healthcare data is also one of the hardest to capture reliably: vital status. Health plans, providers, and researchers rely on accurate mortality information for everything from risk adjustment and quality reporting to population health analytics. Yet in many operational systems, mortality data is […]
From Compliance to Revenue Intelligence
Why we built OnyxOS and how the InteropX integration makes intelligence operational By Susheel Ladwa, CEO, Onyx The Shift For years, the interoperability conversation in healthcare has been about compliance. CMS mandates. API deadlines. Audit readiness. Health plans have done the work. APIs are live. Data is moving. And for most organizations, the compliance question, can we connect?, has been answered. But here is what […]
Putting Clinical Data to Work
Why your data foundation determines your intelligence ceiling Interoperability has made real progress. APIs are live, standards are mandated, and most payers have crossed the compliance threshold. The infrastructure question—can we connect?—has largely been answered. The question now is harder: what does the data actually do? For payers managing HEDIS, Stars performance, risk adjustment, and care gap closure, the answer […]
Portable Trust Credentials: Why Now and How to Get Started
By Mark Scrimshire, Chief Interoperability Officer, Onyx In my previous article, I explained how verifiable connectedness works as a mechanism for portable trust in healthcare interoperability. Today I want to address the practical questions: Why is now the right time to act? What does adoption look like? And what’s the business case? Why Now: The Convergence of Three Forces Three forces are […]
How Verifiable Connectedness Solves Healthcare’s Trust Problem
By Mark Scrimshire, Chief Interoperability Officer, Onyx In a recent article on Healthcare IT Today, I described the missing trust layer in CMS-0057 compliance. The problem is clear: payers and providers need to establish thousands of new API connections, but current trust establishment methods—spreadsheets, attestation forms, manual verification calls—don’t scale. Today I want to explain how we solve this: by making connectedness […]
Where Payer-to-Payer Succeeds or Fails in Production
What payer teams encounter once real data and scale are introduced By Balaji Narayanan, Chief Product Officer, Onyx Payer-to-Payer Data Exchange is a CMS-0057 workflow designed to transfer clinical history between payers when members change health plans. When executed reliably at scale, it establishes consistent data movement and enables downstream use across quality, utilization management, and risk programs. In […]
Provider Directories, Interoperability, and What Medicaid & MA Plans Can Learn from Real-World Connectivity: A Conversation with Defacto Health
By Mark Scrimshire, Chief Interoperability Officer, Onyx Accurate, accessible provider directory data sits at the foundation of almost every function in our healthcare system: member access, network adequacy oversight, referral management, prior authorization automation, and CMS-driven transparency initiatives. As CMS pushes toward nationwide standardization — including the forthcoming National Provider Directory — Medicaid and Medicare Advantage plans […]
Spotlight on PTAC: Strengthening the Data Foundation Needed for True Patient Empowerment
A National Focus on Patient and Data Empowerment The Physician-Focused Payment Model Technical Advisory Committee (PTAC) centered the agenda of its recent public meeting on a unifying theme: how data and health IT can transparently empower consumers and better support providers. PTAC’s role as an advisory body to HHS positions it uniquely to surface the structural challenges preventing patients from fully benefiting from digital tools, coordinated […]