Clover Health has achieved a significant milestone in healthcare data sharing. The Medicare Advantage payer became the first health plan to go live on a CMS aligned network. This marks a turning point for payer interoperability across the United States.
What Is the CMS Aligned Network?
In July 2025, the Centers for Medicare & Medicaid Services (CMS) launched its health tech ecosystem initiative. Major tech companies and healthcare organizations rallied behind the effort. Together, they pledged to meet CMS-led interoperability framework criteria and expand patient access to personal health data.
To qualify as a CMS aligned network, an entity must implement specific interoperability framework criteria. Furthermore, it must respond to patient, provider, and payer requests in full adherence with those standards. This rigorous process ensures that data flows securely and consistently across the healthcare system.
Who Has Pledged to Participate?
Several major organizations have already committed to this framework. On the provider and vendor side, athenahealth, b.well Connected Health, eClinicalWorks, and Epic all pledged to become CMS aligned networks. On the payer side, notable signatories include UnitedHealth Group, Humana, Aetna, Elevance Health, and Clover Health.
How Clover Health Got There First
Clover Health partnered with Kno2, a cloud-based healthcare communication platform focused on interoperability. Together, they built a data exchange workflow directly aligned with CMS interoperability goals. Importantly, the infrastructure runs through Counterpart Health, Clover’s dedicated technology and services arm.
The payer’s commitment was clear from the start. Clover Health’s pledge stated: “We believe in a future where seamless care coordination and data-sharing for the patients’ needs are the norm, not the exception.” This vision drove the company to act quickly and decisively.
The Three-Part Framework in Action
Clover Health describes the operational structure in three distinct roles. First, Kno2 securely routes patient-directed requests across the network. Next, Counterpart Health enables standardized data exchange. Finally, Clover Health responds as the payer with structured clinical and claims information. This clear division of responsibilities makes the system efficient and scalable.
The Technology Powering the Exchange
At the heart of this achievement is Counterpart Assistant, Counterpart Health’s software platform. Unlike typical compliance-driven add-ons, Counterpart Assistant connects hundreds of data sources as a core function. Kevin Holub, Chief Product Officer at Counterpart Health, explained the approach clearly.
“Counterpart Assistant was built from the ground up as a bi-directional interoperable platform,” Holub noted. “These are not bolt-on capabilities or compliance projects. They are foundational components of how the system operates in production.” As a result, joining the CMS aligned network became a fast and natural extension of existing infrastructure.
FHIR Standards Drive Real-Time Data Access
Clover Health now responds in real time to patient-directed requests for clinical and claims data. It uses standardized FHIR (USCDI v3) formats to deliver this information. Consequently, patients gain immediate, structured access to their health records whenever they request it.
Why This Milestone Matters for Patients
This development is far more than a technical achievement. It represents a fundamental shift in how patients control their own health information. Instead of navigating fragmented systems, patients can now direct data requests and receive accurate, timely responses.
Moreover, real-time data sharing supports better care coordination between providers. When physicians access complete patient histories quickly, they make better clinical decisions. Therefore, improved interoperability directly contributes to better health outcomes
What Comes Next for the Industry
Clover Health hopes its early adoption sends a strong message to the broader industry. The company believes patient-directed data exchange is achievable today, not some distant future goal. To demonstrate this, Clover Health will present a live end-to-end response to a patient-authenticated claims data request at HIMSS 2026.
Additionally, this milestone creates competitive pressure on other payers still working toward compliance. As more organizations go live, the CMS aligned network will grow stronger and more useful for all stakeholders. Ultimately, patients, providers, and payers all stand to benefit from this accelerating shift toward open, standardized data exchange.
