Insights from Liz Lewis, AVP Network Management
I spent time at the CMS Health Tech Ecosystem Live First Wave Launch alongside a group of organizations that are actively building toward a more connected healthcare system.
What stood out wasn’t just the number of companies involved, but also how much work has already been done.
There’s been a lot of discussion over the past few years about patient access and whether it is really available. Most of that conversation has centered on data coverage, privacy, and security.
CMS is facing these challenges head-on. The focus has shifted from traditional treatment exchange to making it easier for patients to access their data and how that data is actually used across real workflows. While patient access has been and remains the top priority, the administration has also opened up an opportunity for payers, unlike what we’ve seen to date in national network exchange. The opportunity is right in front of us.
Where the Industry is Right Now
The CMS Health Tech Ecosystem is bringing structure to something the industry has been trying to solve in pieces. To the credit of current national frameworks, much progress has been made in provider-to-provider data exchange for treatment purposes. The same cannot be said for other purposes of use. In fact, by virtue of limiting scalable exchange to treatment only, the industry has opened the door to an increase in misuse and inappropriate requests.
Instead of each organization building in isolation, CMS is defining how different parts of the system are expected to work together. Networks, payers, providers, and apps all have a role, and the expectation is that data can move between them in a way that is consistent, secure, and fast enough to support real use. Plus CMS themselves have committed to participating in the ecosystem and demonstrated that commitment on April 9th.
The foundation for all of this to work is the CMS Aligned Networks. These networks are expected to support moving both clinical and claims data, compliant with FHIR US Core and a minimum of USCDI v3, and respond to requests coming from different parts of the ecosystem. Networks must support this exchange in near real time, using known standards, accepting modern identity, with robust audit logging, and transparency at every step along the way. Networks, and truly all ecosystem participants, are being tasked with meeting the same patient-matching standard at scale for the first time. Where patient matching has often been proprietary or at least non-transparent is now being forced into the open so that all participants have a level playing field. In lieu of a national patient identifier, leveling the playing field for patient matching could have a significant impact on the ability to scale all applicable use cases.
What We Saw in Practice
Across the demos I saw, a few patterns showed up consistently.
Interoperability is Showing Up in Real Workflows with Real Patient Examples
The demos weren’t about access in isolation. Partnerships formed and connections were made. The demos showed how data moves into experiences that people actually use. We saw consumer applications—many of which are already mainstream—utilizing network connectivity to improve not only the consumer experience but truly change how the solution can work for the user just by bringing in clinical data.
That includes things like:
- connecting records without needing to track down every provider
- bringing together claims and clinical data in one place
- using that data to drive next steps, whether that’s AI-guided care navigation or ongoing condition management
It’s a different kind of conversation than what we’ve seen in the past. One that focuses on what happens once the data is in front of someone, and the opportunities that are unlocked as a result.
Identity is Central to the Experience
CMS requires a model where individuals verify their identity once and use that verification to access their data across systems. Leveraging modern identity removes the need to manage multiple portal credentials and reduces friction in the process. We heard from patients in person last week that accessing dozens of portals is simply impossible. In this paradigm, identity tokens are shared between participants, serving as the authentication layer. Modern identity is not conceptually new, but CMS is doubling down on its importance and value in expanding trust. The rally cry is clear: make it easier for patients. Remove burden.
b.well Partnerships Announced During the Event
Alongside the wave of demos, b.well announced new partnerships with three organizations that represent where this ecosystem is heading: health plans, consumer health platforms, and digital therapeutics.
Each partnership is different, but they all point to the same shift. Access to health data is becoming embedded in real products and workflows, rather than being treated as a standalone capability. And as that happens, the line between data access, experience, and outcomes continues to narrow.
These are early examples of how organizations are starting to build on top of a shared foundation, using connected data to improve how they engage individuals, deliver care, and operate behind the scenes.
Humana
Humana’s work is one of the clearest signals of where payer interoperability is heading. They’ve moved beyond simply making data available and are starting to operationalize it, connecting both claims and clinical data across sources in a way that’s accessible to members without relying on traditional portal credentials. This starts to close a long-standing gap in the industry. Member access and backend operations are no longer separate tracks; they’re beginning to run on the same infrastructure.
Noom
Noom is showing what this looks like when it reaches the consumer. By integrating health record access directly into their experience, they’re able to move beyond self-reported inputs and bring in verified clinical data—diagnoses, medications, lab results—to shape how their programs adapt to each individual. That changes the nature of personalization as it’s grounded in a more complete picture of their health. As more applications take this approach, the expectation for consumer health experiences will shift quickly.
Welldoc
Welldoc’s focus highlights the clinical impact of more complete data access. With a broader view of consumer health information, they’re able to deliver AI-powered, personalized support for chronic condition management, especially in areas like diabetes and obesity, where context over time matters. What stood out is how much this reduces reliance on fragmented or incomplete data. Instead of working from snapshots, these solutions can operate by providing a more seamless experience and targeted, actionable insights to the individual. That’s where interoperability starts to show up in engagement and outcomes, not just access.
The Full Workflow with b.well
Up to this point, most of the industry has focused on individual pieces — APIs, access, identity, etc. What matters now is how those pieces operate together.
The b.well demo (below) was presented at the CMS Health Tech Ecosystem Live First Wave Launch, and it walks through that end-to-end workflow, showing how data can be connected, assembled, and used without adding friction for the individual.
This seamless integration is why b.well has also been adopted by a diverse range of healthcare leaders from technology innovators like Samsung, to EHR platforms like eClinicalWorks, MEDITECH, and athenahealth, to major health systems and providers including Cigna, Tennessee Oncology, Cleveland Clinic, DaVita, ThedaCare, and more!
Watch the the demo below to see what it looks like for an individual to:
- verify identity
- connect to multiple sources
- view a unified record that brings together clinical and claims data
- Kill the clipboard workflow
- Conversational AI
It’s a straightforward, easy flow, but it depends heavily on coordination behind the scenes.
Connecting data across the ecosystem to power Kill the Clipboard and Conversational AI
What Enables This Behind the Scenes
The workflow shown above depends on more than connectivity alone. It requires consistent identity, complete data, and infrastructure that can operate at scale across different use cases.
These are the areas where b.well is focused:
Patient Matching
- We manage patient matching centrally across our network, ensuring that data retrieved from different sources resolves to the right individual.
- This work has also extended into the broader ecosystem. Our CTO, Imran Qureshi, contributed patient matching recommendations through the CMS Digital Identity workgroup, which were incorporated into the MVP requirements.
- Reliable patient matching remains one of the biggest barriers to national exchange. Without it, queries fail, records fragment, and data can’t be trusted. Solving this at scale is foundational to everything else.
Complete Patient Data
- We prioritize assembling the most complete view of the individual by connecting across national networks, HIEs, direct integrations, and APIs.
- This includes handling duplication and variation across sources. Our data refinery is designed to normalize, de-duplicate, and structure data so it can be used consistently.
- Data completeness is what makes the rest of this useful, especially for applications like AI, where partial data limits the value of the output.
Support for Multiple Use Cases
- While many know b.well for patient access, that is only one part of the platform.
- We support a range of use cases across patient access, treatment, healthcare operations and payment.
- This allows the same underlying infrastructure to serve both consumer-facing experiences and business workflows.
National Provider Directory
- b.well maintains a national provider directory with more than 2 million providers.
- This supports endpoint discovery and enables more efficient routing of data requests across the network. It also allows us to help scale exchange beyond point-to-point connections.
Audit Logging and Transparency
- As a FHIR-native platform, we use standard AuditEvent frameworks to capture activity across the network.
- This includes logging who accessed data, when, and for what purpose. That level of transparency is critical for trust, compliance, and operational visibility.
HITRUST Certification
- b.well has been HITRUST certified since 2021 and continues to maintain that certification.
- Security and compliance are not separate from interoperability, they are a critical part of what allows it to function reliably at scale.
Why This Matters
These capabilities are not standalone features. They are what make it possible to move from fragmented access to coordinated workflows. Without consistent identity, complete data, and reliable infrastructure, the experiences shown earlier don’t hold up in practice.
What to Expect Next from the CMS Health Tech Ecosystem
The work emerging from this first phase will continue to build over the next several months. We’ll see:
- more organizations participating in CMS-aligned exchange
- broader data availability, including additional clinical content and documents
- continued progress on identity and consent models
- and more applications using this data in ways that go beyond access
The direction is set. The next phase is about expanding and refining what’s already in motion.
Closing Perspective
From where I sit, the biggest change is that the industry is starting to align around how this should actually work.
In a few short months, we went from dreaming to building to testing and on to demonstrating how this vision can become a reality. The foundation is in place. The conversations are more grounded, and the expectations are clearer.
The focus now is on execution—making sure these connections are reliable, scalable, and useful in everyday workflows. Acknowledging where the challenges are and facing them head-on.
That’s where the work continues.
