Humana & Providence Partner to Advance Interoperability in Value-Based Care

The goal is to empower clinicians with timely, actionable insights while reducing administrative complexity and safeguarding patient privacy.

Humana Inc. and Washington-based health system Providence have announced a new collaboration to enhance data exchange between payers and providers, aiming to advance interoperability and support value-based care.

The initiative focuses on building a scalable ecosystem for secure and standardized data sharing using national HL7® Fast Healthcare Interoperability Resources (FHIR®) standards, Da Vinci Project Implementation Guides, and modern APIs.

The goal is to empower clinicians with timely, actionable insights while reducing administrative complexity and safeguarding patient privacy.

“True interoperability should serve clinicians, patients, and payers,” said George Renaudin, Humana’s President of Insurance. “Together with Providence, we’re enabling providers to deliver more effective care and helping our members spend less time on paperwork and more time on their health.”

Fragmented systems and manual processes have long slowed payer-provider coordination and delayed access to critical patient data. The collaboration comes ahead of upcoming federal regulations, including the Centers for Medicare & Medicaid Services Interoperability and Patient Access Rule (CMS-0057), which will soon require organizations to provide standardized, secure access to health information.

Michael Westover, Vice President of Population Health Informatics at Providence, said, “The healthcare industry is overwhelmed by fragmented, inconsistent data formats that make care coordination costly and slow. Because we want to be successful in value-based care contracts, Humana and Providence are building a shared foundation of administrative, financial, and clinical data using national standards and modern technology.”

The first phase of the initiative—automated member attribution for Humana Medicare Advantage members—is set to go live this month. The capability will allow providers to quickly and accurately identify patients under their care, improving coordination and reducing manual processes. Future phases are expected to expand data exchange capabilities to ease administrative burden further and enhance clinical decision-making.

Humana and Providence’s framework aligns with federal interoperability efforts, including the White House’s goal of creating a patient-centric healthcare ecosystem. Both organizations were among 60 participants, including five payers and 11 health systems, that pledged to adopt the CMS Digital Health Ecosystem and transition from paper-based systems to secure, digital data exchange.

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