Accelerating Interoperability: Celebrating the TEFCA 10×10 Pilot Rollout with Premera Blue Cross & Providence Health System
With Opala, Premera Blue Cross and Providence Health System have successfully implemented their TEFCA 10×10 pilot to fully automate supplemental data exchange, value-based contract attribution rosters, and member eligibility lists. We’re thrilled to celebrate this milestone achievement that has resulted in a 40% increase in clinical data exchanged between the payer and provider health system. At Opala, our mission is to eliminate data friction and empower healthcare organizations to exchange information effortlessly and securely – Mission accomplished!
“I applaud Premera and Providence for embracing standards-based data sharing, and Opala for demonstrating the viability of a technical approach that we need to scale if we are to solve healthcare’s quality, access and efficiency challenges. It represents how a small but mighty group of early adopters can embrace the letter and spirit of ASTP’s call to action through the TEFCA for Operations’ 10×10 initiative!”
— Aneesh Chopra, Health IT Innovator and Chief Strategy Officer, Arcadia (June 2025)
More about TEFCA 10×10 Pilots
The U.S. Office of the National Coordinator for Health Information Technology’s Trusted Exchange Framework and Common Agreement (TEFCA) provides a standardized, nationwide approach to health data sharing. In the 10×10 pilot, ten health plans and ten provider organizations test end-to-end data exchange across use cases—laying the foundation for scalable, production grade interoperability.
Use Case Summary
We leveraged two HL7® DaVinci FHIR® implementation guides to automate critical workflows:
- DaVinci CDex API (v2.1.0) Implementation Guide – Automates supplemental clinical data exchange (care gaps, risk codes, wellness visits) to support timely value-based care (VBC) reimbursement.
- DaVinci ATR API (v2.0.0) Implementation Guide – Generates dynamic, real-time attribution rosters and enables on demand member eligibility verification, reducing administrative burden and minimizing eligibility denials.
Use Case | API | Value |
Supplemental Data Exchange | DaVinci CDex API (v2.1.0) | Automates care gap closures, exclusions, and risk code reporting |
Attribution Rosters | DaVinci ATR API (v2.0.0) | Maintains dynamic, real-time rosters for value-based contracts (VBC) |
Member Eligibility | DaVinci ATR API (v2.0.0) | Provides on demand eligibility checks to reduce denials and delays |
Key Benefits Achieved
- Seamless Onboarding: Opala’s interoperability framework provided turnkey connectors to Premera’s plan data and Providence’s clinical systems. Pre-built TEFCA endpoints eliminated strained IT pipelines and accelerated go live.
- Measurable Impact: Achieved a 40% increase in discrete FHIR® transactions compared to legacy batch processes—translating to more complete clinical records exchanged each month and faster insights for care teams.
- Robust Security & Governance: Leveraged TEFCA’s Security and Trust Framework (including identity proofing, secure transport, participant directory, and consent management). All transactions adhere to FHIR® standards and rigorous privacy controls, with Opala orchestrating consent flows.
- Scalable Architecture: Built on modern, event driven microservices, this solution can easily extend to additional data domains—such as prior authorization, patient generated Social Determinants of Health (SDOH), and longitudinal care summaries—paving the way for broad, nationwide adoption.
What’s Next?
With the TEFCA 10×10 pilot complete, Premera and Providence are poised to:
- Expand data domains: Incorporate Prior Authorization Burden Reduction and Provider Access API workflows.
- Onboard additional partners: Bring new health plans and providers into the connected network.
- Demonstrate ROI: Showcase reduced administrative costs, improved patient outcomes, and stronger engagement in value-based models.
As a market-leading interoperability partner, Opala will continue to support production scale implementations—turning these data streams into actionable insights.
Join the Interoperability Revolution
Curious how your organization can leverage TEFCA and FHIR® to break down data silos? Contact Opala today to discover how our end-to-end interoperability platform can accelerate your journey—just as we’ve done with Premera Blue Cross.
