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Amy Gleason: “Payers can also query the network for any clinical data…”

Featuring: Amy Gleason, Acting Administrator, United States Department of Government Efficiency | National

Session 13: The Power of a Mother's Why: Amy Gleason's Motivation to Transform Health Data Exchange

Published December 11, 2025 | Video Starts at 24:27

If I have some other quality measure I can query for that both as a payer and as a value based care provider. And then Payers can also query the network for any clinical data that's for a claim they received in the last 60 days. So that's like an operational piece that we're starting to kind of tip our toes into the water of the operations use cases. (24:27–24:35)

CLAIM

Asserts that payers can query networks for clinical data related to claims received in the last 60 days.

This is an excerpt from a raw transcript. The assertions have not been audited or verified. Tap the video to view the source footage and understand the context.

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Amy Gleason

“Despite meaningful use and all of the efforts that we've done, she now has 47 patient portals.”
Session 13: The Power of a Mother's Why: Amy Gleason's Motivation to Transform Health Data Exchange | Uploaded December 11, 2025 | 04:45-04:52
“There are over 5,000 provider directories out there.”
Session 13: The Power of a Mother's Why: Amy Gleason's Motivation to Transform Health Data Exchange | Uploaded December 11, 2025 | 13:39-13:42
“CAQH said it was over $2 billion a year. I've seen other estimates of $6 billion a year that we waste on administrative costs of just people…”
Session 13: The Power of a Mother's Why: Amy Gleason's Motivation to Transform Health Data Exchange | Uploaded December 11, 2025 | 14:01-14:12
“Over 90% of providers become Medicare providers anyway.”
Session 13: The Power of a Mother's Why: Amy Gleason's Motivation to Transform Health Data Exchange | Uploaded December 11, 2025 | 14:28-14:32
“We do a lot of building things also. So we're working across nine different agencies right now, modernizing systems.”
Session 13: The Power of a Mother's Why: Amy Gleason's Motivation to Transform Health Data Exchange | Uploaded December 11, 2025 | 00:26-00:33
“We're doing a lot of that work at HHS and CMS.”
Session 13: The Power of a Mother's Why: Amy Gleason's Motivation to Transform Health Data Exchange | Uploaded December 11, 2025 | 00:34-00:37
“All the [qualified health entities] pledged to be part of the CMS Align network so they should be able to still go through TEFCA.”
Session 13: The Power of a Mother's Why: Amy Gleason's Motivation to Transform Health Data Exchange | Uploaded December 11, 2025 | 01:36-28:44
“We have not achieved interoperability, as I think, as far as you know.”
Session 13: The Power of a Mother's Why: Amy Gleason's Motivation to Transform Health Data Exchange | Uploaded December 11, 2025 | 06:00-06:04
“In healthcare, we still use the fax machine.”
Session 13: The Power of a Mother's Why: Amy Gleason's Motivation to Transform Health Data Exchange | Uploaded December 11, 2025 | 06:18-06:21
“I launched the CMS Data at the Point of Care initiative.”
Session 13: The Power of a Mother's Why: Amy Gleason's Motivation to Transform Health Data Exchange | Uploaded December 11, 2025 | 06:53-06:57
“The rule I had written to basically take data at the Point of care and have every payer offer it, the effective date of that is January 1…”
Session 13: The Power of a Mother's Why: Amy Gleason's Motivation to Transform Health Data Exchange | Uploaded December 11, 2025 | 07:10-07:20
“We set up something called Report Stream, which the idea was that if you could already do fhir, then you could send the results in FHIR to…”
Session 13: The Power of a Mother's Why: Amy Gleason's Motivation to Transform Health Data Exchange | Uploaded December 11, 2025 | 09:14-09:23
“We did an RFI first in May. Then we had an event at HHS and we did a lot of whiteboarding and sticky note exercises.”
Session 13: The Power of a Mother's Why: Amy Gleason's Motivation to Transform Health Data Exchange | Uploaded December 11, 2025 | 10:22-10:29
“The parts of the HealthTech ecosystem are really the CMS interoperability framework that we established and that is what CMS aligned…”
Session 13: The Power of a Mother's Why: Amy Gleason's Motivation to Transform Health Data Exchange | Uploaded December 11, 2025 | 11:29-11:40
“The CMS aligned networks need to meet patient access and empowerment.”
Session 13: The Power of a Mother's Why: Amy Gleason's Motivation to Transform Health Data Exchange | Uploaded December 11, 2025 | 11:29-11:40
“All of these pledges have to be live in the first quarter of 2026.”
Session 13: The Power of a Mother's Why: Amy Gleason's Motivation to Transform Health Data Exchange | Uploaded December 11, 2025 | 11:40-11:44
“We think that networks have been forced into trying to find a way to be sustainable instead of finding networks that are already…”
Session 13: The Power of a Mother's Why: Amy Gleason's Motivation to Transform Health Data Exchange | Uploaded December 11, 2025 | 12:16-12:24
“We did just launch our first sandbox release last week.”
Session 13: The Power of a Mother's Why: Amy Gleason's Motivation to Transform Health Data Exchange | Uploaded December 11, 2025 | 14:48-14:52
“We are launching Identity both on our provider directory so providers can validate their identity and on medicare.gov.”
Session 13: The Power of a Mother's Why: Amy Gleason's Motivation to Transform Health Data Exchange | Uploaded December 11, 2025 | 15:59-16:08
“We expect all this to be live in Q1 2026.”
Session 13: The Power of a Mother's Why: Amy Gleason's Motivation to Transform Health Data Exchange | Uploaded December 11, 2025 | 19:22-19:28
“For our CMS interoperability framework, if a provider has a valid license, they validated their identity in the national provider directory…”
Session 13: The Power of a Mother's Why: Amy Gleason's Motivation to Transform Health Data Exchange | Uploaded December 11, 2025 | 21:25-21:40
“By the summer we want everything to be FHIR or FHIR mediated.”
Session 13: The Power of a Mother's Why: Amy Gleason's Motivation to Transform Health Data Exchange | Uploaded December 11, 2025 | 22:34-22:38
“In the provider directory all of the networks will have to publish their participants and how to connect to them as well as information…”
Session 13: The Power of a Mother's Why: Amy Gleason's Motivation to Transform Health Data Exchange | Uploaded December 11, 2025 | 22:42-22:52
“Payers and value based care providers can also query these networks to get quality measure data.”
Session 13: The Power of a Mother's Why: Amy Gleason's Motivation to Transform Health Data Exchange | Uploaded December 11, 2025 | 24:09-24:15
“We really think this kind of personalized AI friend, lack of a better word, doctor friend, could really be a companion that could not…”
Session 13: The Power of a Mother's Why: Amy Gleason's Motivation to Transform Health Data Exchange | Uploaded December 11, 2025 | 26:33-26:46
“We learned from our pledge form that we had 72 people pledged to be networks.”
Session 13: The Power of a Mother's Why: Amy Gleason's Motivation to Transform Health Data Exchange | Uploaded December 11, 2025 | 30:15-30:21
“Several people that pledged as a payer and they were not a payer.”
Session 13: The Power of a Mother's Why: Amy Gleason's Motivation to Transform Health Data Exchange | Uploaded December 11, 2025 | 30:27-30:31
“Several people were providers and were not providers.”
Session 13: The Power of a Mother's Why: Amy Gleason's Motivation to Transform Health Data Exchange | Uploaded December 11, 2025 | 30:30-30:34
“We added a friends of the ecosystem [category].”
Session 13: The Power of a Mother's Why: Amy Gleason's Motivation to Transform Health Data Exchange | Uploaded December 11, 2025 | 30:39-30:42