In today’s healthcare environment, data analytics is no longer optional—it’s foundational. Yet for all the power data holds, a persistent and historically under-addressed challenge remains: the fragmentation of patient data across systems and providers. At the heart of this problem lies a concern shared by patients and providers alike—how do we ensure that critical health information moves securely, accurately, and seamlessly through the care continuum?
The Analytics Behind a Fragmented Patient Experience
According to the most recent systematic review of digital patient portals, only a fraction of patients consistently engage with systems designed to empower them. Despite notable improvements—such as secure messaging, access to lab results, and chronic disease monitoring—studies continue to report limited uptake due to privacy concerns, time constraints, and lack of interoperability.
Statistics show:
- Over 60% of patients report difficulty transferring records between specialists and primary care providers.
- Only 30% of digital patient portal users share their records with new providers, citing distrust in how their data is managed.
- A 2024 CMS report found that duplicative testing due to missing records costs Medicare over $5.3 billion annually.
- Meanwhile, chronic disease patients who use fully integrated digital tools experience up to 17% fewer emergency visits, underscoring the value of coordinated, transparent care.
These gaps in data-sharing aren’t merely administrative—they are clinical liabilities. The stakes are even higher for Medicaid and Medicare populations, who often manage complex, multi-provider care plans. The inability to access complete medical histories can result in worsened outcomes, unnecessary hospitalizations, and inflated costs.
A Trump-Era Comeback: The Next Phase of Radical Transparency
In early 2025, President Trump reentered office with an ambitious regulatory agenda focused on empowering patients, dismantling data silos, and slashing healthcare costs through radical transparency.
The centerpiece of this initiative? An Executive Order titled “Making America Healthy Again,” which revives and expands upon 2019’s price transparency mandates. Here’s what it means for the Medicare and Medicaid ecosystem:
- Actionable Price Transparency
- Hospitals and health plans must disclose real, negotiated prices—not estimates—for every item and service.
- A standardized, machine-readable format will be required across the board, eliminating the current patchwork of non-comparable pricing tools.
- Health plans will be mandated to post the actual costs of prescription drugs, ending years of obfuscation by pharmacy benefit managers (PBMs).
- Enforcement Muscle
- The Secretary of HHS has 90 days to revamp enforcement protocols.
- Noncompliant providers could face fines, public listing, and exclusion from federal contracts.
- Expansion of MyHealthEData Initiative
Revived and updated, the MyHealthEData Initiative aims to ensure that patients—not insurers, not providers—control their medical records. CMS’s Blue Button 2.0 platform is leading the charge, offering:
- Secure, patient-directed data sharing.
- Interoperable access across EHRs.
- Integration with third-party applications for personalized health management.
By extending these capabilities across all Medicare and Medicaid providers, the Trump administration plans to unleash competition, reduce duplication, and elevate care coordination.
The Bottom Line: Transforming Fragmentation into Empowerment
As Med-Prov, LLC works with healthcare organizations navigating this shifting terrain, one message is clear: Adaptation is survival. From RegTech implementation to compliance audits, stakeholders must:
- Embrace patient-centered data sharing.
- Invest in interoperable technologies.
- Prepare for stricter enforcement and more transparent pricing.
The Trump administration’s renewed push for radical transparency and patient data empowerment isn’t just a policy—it’s a signal. A new era of healthcare is emerging, one in which patients are informed, data is mobile, and compliance is digitally enabled.
At Med-Prov, we’re here to help you stay ahead of the curve—because the future of healthcare isn’t just transparent, it’s transformative.
RegTech to the Rescue: A Catalyst for Compliance and Innovation
To address these systemic inefficiencies, healthcare organizations are increasingly turning to RegTech—regulatory technology solutions that use automation, AI, and blockchain to manage compliance and improve data integrity.
RegTech tools can:
- Audit provider compliance with CMS transparency rules in real-time.
- Detect anomalies in claims that signal data silos or billing gaps.
- Facilitate secure patient consent protocols that allow data to follow the patient.
- Standardize formats across EHRs, reducing mismatched information between payers and providers.
For Medicare and Medicaid providers, RegTech is more than a luxury—it’s becoming essential. As CMS tightens its enforcement mechanisms, organizations that embrace smart compliance will be best positioned to deliver value-based care. Tools that once seemed futuristic—like API-enabled patient dashboards, blockchain audit trails, and automated prior authorization systems—are quickly becoming the new norm.
About Med-Prov, LLC
Med-Prov, LLC is a leader in Medicare and Medicaid compliance consulting. We specialize in helping healthcare organizations reduce costs, improve quality, manage risk, and navigate evolving regulatory landscapes. For support implementing transparency initiatives or compliance audits, contact us here: Med Prov, LLC | CMS Industry Experts | Contact
Advocate. Educate. Collaborate.