Officials Build Digital Backbone for Federal Health Care Reform

President Donald Trump formally introduced his long-awaited health care reform plan last month, the Great Healthcare Plan, and federal health agencies are already working to implement it.  

The plan is largely aimed at reducing prescription drug costs and lowering insurance premiums. But embedded within the plan, and in related administration initiatives, is a significant technology component aimed at reshaping how Americans access pricing information, purchase medications and interact with the health care system. 

Deputy Secretary of Health and Human Services Jim O’Neill recently said the department’s main goal is “strengthening and scaling a single, trusted, interoperable backbone that works across programs, across payers, across providers and across tech platforms, rather than creating a parallel system to add complexity without delivering value.”  

Building a Federal Health Tech Infrastructure

The administration has tied the health care agenda to a broader push for digital modernization across federal health agencies. The Centers for Medicare and Medicaid Services has advanced its Health Technology Ecosystem initiative designed to improve interoperability and the secure exchange of patient data between providers, insurers and patients. 

CMS officials said the goal is to enable smoother sharing of electronic health records, streamline payment systems and support more personalized digital health tools. Amy Gleason, strategic advisor to CMS, said they had to first build trust in the industry in order for people to feel comfortable with health record databases.  

“One of the main issues is trust in the industry, people are saying, ‘I don’t know if it’s actually Amy trying to get her records. What if it’s somebody trying to take them?’ Or if a provider is trying to get the information, how do I actually know the provider is the right person getting the information?” she said. “And so we’ve put a lot of identity work in place to kind of build that trust, and we’re using CLEAR, ID.me and login.gov for that, so a person can validate who they say they are and establish that trust.” 

Next, Gleason said the agency established a “vision of an interoperability framework” that would not only allow patients to have all their health information in one place, but would let them see who else is accessing their information, similar to a credit report.  

“We basically wanted patients to be able to use that identity to get all their information without having to remember every doctor they’ve ever been to, or sign into all these different patient portals,” she said. “We want to make that easy for patients and let them see where their data is going, kind of like your credit report, where you can see who’s accessing your credit, we want people to see who’s accessing your medical information as well.” 

Though not formally branded as part of the Great Healthcare Plan, the modernization initiative aligns with the administration’s broader argument that inefficiency in federal systems contributes to higher health care costs. 

Prescription Database

Earlier this month, the White House launched a federal prescription pricing platform known as TrumpRx, a government-run website that allows patients to compare prices and purchase some medications. The platform reflects the administration’s “most-favored-nation” pricing policy, which aims to align U.S. drug costs with lower international rates. 

“You’re going to save a fortune,” Trump said during the site’s press conference. “And this is also so good for overall health care.” 

The digital marketplace model is intended to give patients direct visibility into medication costs. By making drug pricing searchable and comparable online, the administration argues that technology can serve as a cost-control mechanism through transparency and competition. 

The actual impact of the database remains unclear. During a recent University of Pennsylvania panel discussion at its Institute of Health Care Economics, the analysts suggested the program could benefit the uninsured but may not have a significant impact on the people who already have health insurance since purchasing through TrumpRx may prevent payments from counting toward insurance deductibles and annual out-of-pocket maximums. 

Legislative Path Forward 

The Great Healthcare Plan remains a framework rather than policy and the burden is on Congress to expand on the administration’s outline. In order for the entire plan to be enacted, Congress would need to determine funding levels, enforcement mechanisms, implementation timelines, then draft and pass the legislation. The technology components of the plan would require regulatory coordination between federal agencies in addition to data formatting standards for interoperability before full implementation could occur.