Health care data provides greater affordability and access

By Thomas Keane, M.D., M.B.A

This is a lightly edited segment of testimony from the Senate Committee on Health, Education, Labor and Pensions hearing entitled “Transforming health care with data: Improving patient outcomes through next-generation care.”

My top priority is fostering greater data liquidity in the U.S. health care system so that patients and their clinicians are in the driver’s seat. I see how modern data standards, combined with artificial intelligence (AI), can make health care more affordable, accessible and can support improved health outcomes.  No patient should be treated like a stranger at their next health care encounter simply because their records did not follow them. Patients and their caregivers must be able to see accurate, up-to-date health information in one place, rather than spending days or weeks chasing records that should be available in seconds. Access to data will empower patients to take control of their health and inform providers’ clinical decision-making, leading to improved care and patient safety. 

Our work at ASTP/ONC will not only help realize these goals, but will also improve public health, and accelerate scientific research and discovery.   Affordability and Access For too long, health care has been too expensive, with crushing administrative burdens, workforce shortages, and uneven access to high-quality care. America spends nearly one-third of the federal budget on health care yet ranks near the bottom of developed nations in health care outcomes. 

CMS recently reported that the U.S. national health expenditure (NHE) grew 7.2% to $5.3 trillion in 2024, or $15,474 per person, and accounted for 18% of Gross Domestic Product (GDP). Spending on Medicare, Medicaid, private health insurance, and out-of-pocket costs all continue to increase. Health IT plays a role in reducing costs and we are doing all we can to support the Administration’s focus on making health care more affordable.  

To that end, in July 2025, we published the Health Data, Technology, and Interoperability: Electronic Prescribing, Real-Time Prescription Benefit and Electronic Prior Authorization (HTI4) Final Rule, which makes important policy changes that will result in doctors and their patients having unprecedented real-time access to prescription drug information.

This information will help prescribers identify the most appropriate, cost-effective treatments while reducing unnecessary delays in the prior authorization process.  Thanks to this rule, health care providers will be able to compare drug prices, view out-of-pocket costs, and access prior authorization requirements as part of their workflow. Instead of two clinicians’ staff spending an hour on the phone and fax just to discover that a prescribed drug is not covered by insurance, real‑time benefit tools let the providers see covered alternatives at the point of care, allowing them to choose the option the patient can actually pick up. Showing a provider the patient-specific cost at the time of prescribing results in savings of hundreds of dollars for common medications for diabetes, and thousands of dollars for higher-cost specialty drugs. 

For a senior on a fixed income or a parent managing a child’s chronic illness, the ability of a prescriber to choose a covered, low-cost drug can mean the difference between skipping a prescription and being able to afford an essential medication. This rule also establishes criteria for certified health IT, which most providers use today, to support the necessary functions to facilitate electronic prior authorization, including automation. 

Developers can begin testing for certification to these criteria now, and we expect to see the first health IT modules completing certification over the next few months. When health IT is certified to these criteria are fully implemented, we estimate that electronic prior authorization will save millions of hours of clinician time annually, totaling $19 billion in labor cost savings over ten years.  Today, a physician’s office might fax the same information multiple times to different insurers, while a patient waits for weeks for an MRI. With electronic prior authorization built into certified health IT, the request can be submitted once from the electronic health record and tracked electronically, cutting days or weeks from that wait. 

That savings is time that can be spent with patients rather than on paperwork. That’s the difference between a cardiologist wasting an afternoon on hold with a health plan and investing time in caring for her patients. These reforms directly address a major pain point: patients, caregivers, clinicians, and payers continue to struggle with information exchange barriers, especially in the case of prior authorization, where a lack of adopted standards and coordination across stakeholders leads to administrative burdens and care delays. 

Read the full testimony here.

Listen to the full hearing here.

Dr. Thomas Keane serves as the ninth national coordinator for Health Information Technology. An engineer and physician, Dr. Keane previously served in the ONC and also as a senior advisor to the Deputy Secretary of HHS.

_{*The opinions expressed in this column are those of the author and do not necessarily reflect the views of HealthPlatform.News.}