New Solution Aims to Significantly Reduce Administrative Burden for Health Plans and Providers Across Massachusetts
WALTHAM, Mass., June 24, 2025 /PRNewswire-PRWeb/ -- The Massachusetts Health Data Consortium (MHDC), in partnership with ZeOmega, Inc., has launched a network solution to automate prior authorization and streamline clinical data exchange for quality measurement among Massachusetts health plans and providers.
This initiative expands upon MHDC's longstanding New England Healthcare Exchange Network (NEHEN) service, which currently supports claims, eligibility, and referral transactions. The upgraded network now incorporates Fast Healthcare Interoperability Resources (FHIR) APIs to enable real-time, automated prior authorization and clinical data exchange through a single connection. NEHEN supports compliance with the CMS Interoperability and Prior Authorization Final Rule (CMS-0057-F) and leverages HL7 Da Vinci Implementation Guides for prior authorization. It will also support a FHIR version of MHDC's Quality Measurement Specification to improve clinical data sharing for quality measurement and reporting.
"This initiative brings data exchange into the 21st century," says David Delano, former NEHEN Executive Director and current Senior Director of Services at MHDC. "We're applying modern standards to automate and simplify one of the most burdensome parts of care delivery. It's a long-overdue step toward a faster, smarter, and more connected care delivery system."
The new solution has already garnered significant support from leading Massachusetts health plans. Early adopters include Blue Cross Blue Shield of Massachusetts, Point32Health, (the parent organization of Harvard Pilgrim Health Care and Tufts Health Plan), and WellSense Health Plan. These organizations are among the first to begin integrating with the enhanced NEHEN platform, helping to lay the foundation for broader statewide adoption.
The NEHEN network, health plan-funded, marks a bold step toward a more efficient, interoperable, and patient-centered healthcare infrastructure. This investment goes beyond financial support—it signals a deep, strategic commitment by health plans to address some of the most persistent challenges in healthcare: administrative and clinical data exchange burden that strains resources and relationships. By proactively funding this solution, leading health plans are demonstrating true partnership with their provider counterparts, working to eliminate long-standing friction caused by manual processes, redundant documentation, and opaque workflows—particularly in areas like prior authorization. This collaboration paves the way for a more unified and transparent system, where health plans and providers are better aligned in their shared goal of delivering timely, high-quality care to patients across the Commonwealth.
Tony Sheng, Vice President of Interoperability Solutions at ZeOmega, shared his perspective on the collaborative effort: "ZeOmega is excited to partner with MHDC to deliver a next-generation interoperability service powered by HealthUnity that enables secure real-time exchange of administrative and clinical data between health plans and providers at scale. With a single connection, participants can access the entire network, streamlining integration and onboarding through reusable standards-based workflows. The network ensures consistency, compatibility, and trusted data exchange by managing conformance, security, and intelligent routing between participants."
"This is a milestone achievement," says Denny Brennan, Executive Director at MHDC. "Our work with ZeOmega, combined with the input and commitment of Massachusetts health plans and providers, reflects a strong and urgent demand to reduce the growing burden of administrative and clinical data exchange. This network is not just a technical solution—it is a collaborative response to the challenges facing our healthcare system."
About the Massachusetts Health Data Consortium (MHDC)
MHDC is a non-profit organization focused on improving healthcare quality, transparency, and efficiency through better access to and exchange of health data. Through collaborations and innovations like NEHEN, MHDC continues to lead the way in transforming healthcare information infrastructure across New England.
About ZeOmega, Inc.
ZeOmega empowers health plans and providers with population health management solutions that enable high-quality, cost-effective care. With advanced technology and deep industry expertise, ZeOmega delivers scalable solutions to optimize outcomes, improve workflows, and enhance care delivery.
Media Contact
Lauren Bedel, Massachusetts Health Data Consortium, 1 (781) 419-7800, [email protected], https://www.mahealthdata.org/
SOURCE Massachusetts Health Data Consortium
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