CMS’ New ‘App Store’ Is Trying to Turn Interoperability Into a Digital Health Distribution System Leave a comment

This month, the Centers for Medicare & Medicaid Services announced the first wave of tools and partnerships under its Health Tech Ecosystem initiative — including the novel Medicare App Library — which seeks to create a more consumer-driven, app-based health data infrastructure.

The agency said that more than 700 companies have signed onto the voluntary initiative since it launched last July. By giving updates on the effort’s progress and partnerships, CMS is aiming to provide proof that it’s working with industry partners to move the initiative from policy to product development and then to real-world deployment.

This marks CMS’ most concrete steps yet toward turning its broader interoperability push into an actual consumer-facing distribution system for health data and digital health tools. 

Under the initiative, patient data doesn’t stay siloed within individual apps. Instead, participating companies connect to CMS-backed data-sharing networks — including health information exchanges and interoperability frameworks — that allow data to flow directly into clinicians’ workflows. That means information generated by platforms like Welldoc or Noom, two companies participating in the Medicare App Library, can be accessed alongside clinical data, rather than requiring patients to manually share it.

Participants say that the initiative is transforming interoperability from a technical mandate to a tool that can actually enable more personalized care.

Launching a new ecosystem

The most significant update CMS gave this month about its Health Tech Ecosystem initiative was the rollout of the library that will serve as a centralized directory for vetted digital health apps. CMS said it uses the term “apps” to encompass mobile or web applications, digital health platforms, and tech-enabled care services or care delivery tools.

In effect, CMS is attempting to create a healthcare “App Store,” where the Medicare App Library functions as the distribution channel, interoperability standards serve as the underlying APIs and health tech companies act as the developers building on top of the system. 

The agency highlighted more than 50 companies whose apps are either already listed in the library or are currently undergoing the vetting process for inclusion. Companies can apply to be included in the app library and are then vetted by CMS on factors like interoperability, privacy and alignment with its broader data-sharing standards.

Some of the companies whose apps are available include Welldoc, January AI, Flexpa and HealthEx. A few of the companies that are still finishing the final checks are Zocdoc, Noom, Polygon Health and Xealth. 

Ultimately, the companies participating in the ecosystem are joining a network designed to give patients the ability to access and share their health data through trusted applications, CMS said. 

Through the ecosystem, CMS is setting common technical and security standards so different apps can connect to health data in a consistent way. The agency said Medicare is serving as the initial wedge for the model because it provides a defined beneficiary population through which to standardize data access and scale adoption of approved apps.

The ecosystem also enables patients to use these apps without going through their health plan. 

Traditionally, if a digital health tool wanted clinical, claims or eligibility data, it often had to rely on custom, one-off integrations with each provider or payer. CMS is seeking to change that so patients can authorize access directly and not have to deal with their insurer acting as an intermediary gatekeeper.

Real-world utility for patients

To operationalize the ecosystem, CMS has partnered with organizations like health information network eHealth Exchange and data platform b.well Connected Health to help build out the data infrastructure layers needed to connect patients, data holders and app developers. 

Kristen Valdes, CEO of b.well, thinks CMS is right in its thinking that healthcare needs to abandon document-based exchange in favor of real-time, patient-mediated data access.

It’s not as if digital data exchange networks or shared interoperability standards are new innovations — but now CMS is starting to go beyond voluntary alignment and quietly incentivizing participation, she explained.

Effectively, the role of interoperability networks is changing from optional infrastructure to a required participation point for companies if they want meaningful access to Medicare-connected patients and data flow. CMS is now pushing for “CMS-aligned networks” — in which patients’ data access requests are no longer treated as a secondary use case, but as a mandatory requirement that participants must support by default, Valdes noted.

She thinks this reorientation is what makes the current effort different from earlier federal interoperability initiatives that lacked consistent incentives for patient-facing data access.

Valdes also said CMS’ Health Tech Ecosystem initiative goes further to improve data access than popular interoperability frameworks like TEFCA or Carequality because it’s designed to prioritize faster implementation and more direct patient access.

“With CMS’ health tech ecosystem, these [efforts] are like speed boats that are racing to figure out what the future can really look like. TEFCA is a little bit slower. It has a lot of governance. It has a lot of standard operating procedures,” she remarked. 

The pace of this initiative is much quicker than that of past efforts because CMS is not just enabling data access, it’s already defining use cases for it, Valdes pointed out.

The three consumer categories CMS has prioritized are conversational AI, chronic disease management and eliminating paperwork. The app library is already integrating tools from all these categories — like Microsoft’s Copilot on the conversational AI side, Vida Health and Virta Health for chronic disease, and Flexpa for digital data access.

Taken together, Valdes said these use cases are designed to turn interoperability into something patients can actively use and benefit from, rather than just a backend data exchange function. 

For instance, conversational AI tools allow patients to query their full medical histories in natural language so they can better understand complex data, she explained. Chronic disease apps often focus on conditions like diabetes and obesity, where continuous access to data can support more personalized and effective care.

And CMS’ push to move healthcare away from document-based processes — dubbed the “kill the clipboard” effort — aims to get rid of repetitive intake forms by letting patients pre-populate their clinical information and share it directly with providers at the point of care. 

To Valdes, these three categories show that CMS is trying to ground the ecosystem in real-world consumer utility.

Providing better care

The new ecosystem seeks not only to benefit patients, but providers as well, according to Anand Iyer, chief AI officer at Welldoc, a chronic conditions management company that has partnered with both CMS and b.well.

Without continuous data, providers give more generic advice, he noted. With real-time data, he said they can provide clinical coaching that is much more personalized.

Iyer said integrating with b.well’s continuous data platform and participating in CMS-aligned networks is giving Welldoc’s clinicians the information they need to provide step-by-step guidance rather than blanket advice — “the Google Maps of healthcare,” as he put it.

“If your hemoglobin A1C is 10, and you want it to become seven, okay? Let’s say that you’ve gotten it down to nine, and you still need to get it down to eight and seven, but I don’t have that data flow through from my lab. What do I tell the patient? Well, I can tell them, keep on exercising, keep on eating healthy. I can give them general feedback, like a health and wellness app would do, but I’m not giving them the precise turn-by-turn directions,” he explained.

By contrast, easy access to patient data allows doctors to give more specific recommendations, such as quickly adjusting medications based on lab trends, tailoring coaching around glucose or blood pressure fluctuations or intervening earlier when data shows a patient is drifting off track.

Aaron Severs — chief product officer at weight loss company Noom, which is also participating in CMS’ ecosystem — said that access to longitudinal health records is critical as his company completes its transition from a wellness app to a clinical care company prescribing GLP-1s and providing weight management programs.

Being a part of CMS-aligned networks allows Noom to tailor its coaching and patient education based on a user’s medical history, Severs noted. For example, patients with prediabetes can be routed into prevention-focused content, while those with diabetes can receive resources for glucose forecasting, he explained.

The company also uses medication data, such as usage and tolerance of GLP-1 prescriptions, to adjust nutrition and activity recommendations in real time, Severs added.

He pointed to CMS’ ACCESS model, which is slated to begin July 1, as a broader extension of the ecosystem.

The ACCESS model seeks to rewire traditional Medicare around patient outcomes and cost control by allowing providers to use digital tools, nontraditional services and care teams that are not typically reimbursed under fee-for-service. Participating providers will take on responsibility for quality and the total cost of care, with the opportunity to share in savings if they improve outcomes and decrease spending.

In that framework, improved data connectivity is not just an interoperability upgrade, but a prerequisite for measuring and proving outcomes at scale. For Noom, that means its programs can be evaluated more directly on metrics like weight loss, A1C reduction and sustained behavioral change when patients opt into data sharing. 

Severs and the other healthcare experts interviewed for this article are pleased that CMS is no longer treating interoperability as a back-end technical goal, but now as a necessity to deliver the best care. The question is whether this healthcare “App Store” can scale beyond pilots into a durable model for the industry.

Photo: Blue Planet Studio, Getty Images