By Heather Landi Jan 22, 2026

The Centers for Medicare & Medicaid Services sees the health tech ecosystem initiative working in tandem with other government-backed data exchange efforts, like the Trusted Exchange Framework and Common Agreement. (ismagilov/GettyImages)

It's been almost six months since the Trump administration unveiled a sweeping health tech initiative that aims to modernize Medicare and advance next-generation digital health for patients, including conversational artificial intelligence, digital IDs and easier ways to access health data.

The Centers for Medicare & Medicaid Services' (CMS') 2026 tech goals center on two priorities—promoting an interoperability framework and increasing the availability of apps that help Medicare patients manage diabetes and obesity, access conversational AI tools and replace paper intake forms with digital check-in.

Since July, more than 600 healthcare organizations have joined the Health Tech Ecosystem pledge, which is completely voluntary, according to Amy Gleason, acting administrator, U.S. DOGE Service, and strategic advisor to the CMS. The goal is to have tangible results from these pledges go live by March 31, she said on the sidelines of the J.P. Morgan Healthcare Conference last week.

The CMS will then build on those efforts by setting goals for the second quarter, ending in July, that require apps to move to the Fast Healthcare Interoperability Resources standard and add features like record locator service and event notifications that advance interoperability beyond admission, discharge and transfer alerts, Gleason said.

She believes the timing is right to advance patient-facing AI that can enable care that is more timely and personalized. There's an alignment around consumer expectations, technology capabilities, advancements with AI and industry readiness to tackle the friction that stymies health data sharing, she noted.

"It's healthcare's moment. I think we've been talking about this for a long time," said Gleason, who started her career in nursing and then moved into healthcare technology, including building and implementing electronic medical records and practice management technologies.

"When we did our RFI (request for information) in May and really started convening people in June, it feels like the industry is also tired of this finally, and it's breaking down some of the walls. And I really think AI is driving a lot of the behavior change because you can't do all this without the data. If you don't have the data, AI doesn't work very well. I think AI is shifting people's thoughts and really starting to break things down."

The CMS sees the health tech ecosystem initiative working in tandem with other government-backed data exchange efforts, like the Trusted Exchange Framework and Common Agreement (TEFCA).

"We see ourselves working with TEFCA as a floor and a ceiling," Gleason said. "There's the regulatory way to do things, and TEFCA and ASTP/ONC have to deal with more of the regulatory piece, which is just a slower process. We're really trying to just challenge the industry to do things more in a tech manner. You don't do 10-year tech projects anymore. You do iterative development and build quickly, and if it doesn't work, you throw it away early, and you iterate quickly. As we find things that work, and iterate on that, then if we need the regulation, they can come back up underneath us and raise the floor."

Officials from the federal government had a big presence at JPM this year and were actively engaging with the healthcare industry. The CMS wants to spur private sector innovation to move the needle on interoperability, digital health and patient-facing AI tools, Gleason noted.

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"It's all about getting data to share between people in the private sector. Our role is really convener and common infrastructure like provider directories," she said.

Since the July CMS announcement, healthcare AI and digital health companies have been racing to launch tools that give patients better access to health data. HealthEx, a collaborator on the CMS' health tech initiative, launched a platform to provide real-time patient access to complete health records. The company, working with industry partners, aims to create an “Apple Wallet” for health records that doesn't require patients to do multiple patient portal logins., executives said.

CLEAR, the identity verification technology company commonly used at airports, inked a contract with the CMS in December as part of the ’ “Kill the Clipboard” initiative.

Ricky Bloomfield, M.D., chief medical officer at Oura who previously led health informatics at Apple, sees the CMS' efforts as a continuation of work to help consumers more easily access their health data.

"What I like about their approach is it's voluntary. They're trying to lower the bar to get more people to participate and to participate for the right reasons," Bloomfield said.

"At Oura, our members want to better understand their data. They want to bring the high-quality sensor data from the Oura ecosystem and their clinical data together so that those experiences can be more personalized. The work that CMS is doing to reduce the barriers for all of those pieces is really exciting for us," Bloomfield said.

Last year, Oura launched an AI agent, called Oura Advisor. As part of its pledge to the CMS health tech ecosystem initiative, the company is building on that to incorporate clinical data to give users more personalized insights into their health, he said.

In the lead-up to JPM, Anthropic launched Claude for Healthcare, AI tools and resources purpose-built for providers and payers. HealthEx is partnering with Anthropic to integrate patient health records into Claude as part of the AI company's healthcare offering.

OpenAI also launched ChatGPT Health to connect users' health records with the chatbot as well as a suite of tools for healthcare enterprises.

Gleason was optimistic about the healthcare announcements from Anthropic and OpenAI—both companies signed the health tech ecosystem pledge, so the expansion into healthcare wasn't entirely a surprise.

"They committed in July to do this, and I think they're coming out a little ahead of the March 31 deadline," Gleason said. "The networks aren't quite all there yet to meet some of the patient requests; the patients that use it now may not get all of their medical records right away, or there might be glitches, but that's what we're working out and trying to test out and get people to use it so that we can fix the challenges and get it going better by March 31."

Arda Kara, senior advisor for technology at the CMS who was also on the scene at JPM, said the announcements from Anthropic and OpenAI were a "step change" for the industry. "There's going to be a bunch of learning that has to happen. We have to be thoughtful in how we monitor and keep improving, but it's a long-needed step change," Kara said on the sidelines of JPM.

The CMS plans to create an app store of vetted digital health solutions, and these apps will be required to use modern identity solutions and integrate AI chatbots to provide Medicare beneficiaries with information about healthcare access. With a focus on privacy and security, the CMS will require apps to adhere to the CARIN Alliance Code of Conduct, a framework for how consumer-facing apps should use, manage and exchange personally identifiable health information, or be certified through the Digital Medicine Society, according to Gleason.

The agency also has made its own commitments to build a National Provider Directory and will respond to patient and provider queries and share Blue Button claims data through CMS-aligned networks. "That helps the industry to have best practices to point to," Gleason said.

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The CMS also is lighting a fire to these efforts by putting incentives in place through new payment models.

In December, the CMS Innovation Center debuted a new 10-year model to encourage the use of technology to treat chronic diseases, which could be a boon for health tech companies that have struggled with reimbursement. The Advancing Chronic Care with Effective, Scalable Solutions (ACCESS) Model is a payment program that would offer stable, recurring payments for technology used to treat diabetes, hypertension, chronic kidney disease, obesity, depression and anxiety.

The Health Tech Ecosystem was a "precursor" to the ACCESS model, Gleason said. "We wanted to see how many people would come and innovate with us voluntarily, but we were always planning incentives from the beginning. The ACCESS model is kind of one of those, the Rural Health Transformation fund is another," she said. "With the CMMI team, it's always their job is to innovate and try things and figure stuff out, and then the things that work get incorporated into the rest of the system. Our job as the ecosystem is to drive the innovation and then find the right incentives to help providers participate more."

"ACCESS was really meant to be in tandem with the ecosystem," Kara said. "The whole idea is it's patient empowerment and it's paying for outcomes rather than volume of care."

Patient-facing AI is here, ready or not

As health tech companies move quickly to ride this wave of AI innovation, are payers and health systems ready? Many providers and insurers are working through what it will take to deploy patient-facing AI tools safely and responsibly, according to participants who attended a closed-door roundtable during the JPM conference.

"The conversation was a lot around, how do you activate patients? How do you overcome biases when some providers don't necessarily want their patients to have all that data? How do we all work together to really empower them, and how do we get wearables and all the other kind of data that's outside of the healthcare system into the mix as well?" said Gleason, who attended the roundtable.

The roundtable, hosted by HealthEx, included executives from major payers, health systems, digital health and wearables companies, AI startups and federal health officials, according to HealthEx CEO Priyanka Agarwal, M.D., on the sidelines of JPM.

"A lot of the conversation so far in healthcare has focused a lot on how AI is going to help staff, how it helps doctors. We're in this moment now where really we're thinking about how AI is going to help consumers," Agarwal said. "There was a lot of enthusiasm around this idea of, 'We want to make this available, but do it in the right way, having the right benchmarking, being able to evaluate how it's going to work.'"

Providers and payers also are thinking through how AI chatbots like ChatGPT Health may increase demand for medical care.

"So far, these efforts are focused on information, consumer empowerment, letting folks understand their health. That's going to open up a demand for 'I want to talk to a doctor about this, I want to get care,'" Agarwal said.

The challenge for providers will be bridging that gap between consumer-facing AI tools and getting patients to care within traditional healthcare system.

"One of the conversations from the AI teams was that we have this infrastructure that's really well set up for agentic action. So, how do we bring together identity, consent, permission, data to then take the next step and support enabling real-world care? I think there's generally a feeling that we're in a moment in healthcare that we haven't seen before. It's exciting to think about what the healthcare journey could look like for the average American," Agarwal said.

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Through its partnership with Anthropic, HealthEx enables Claude users to connect their medical records directly to the AI.

"From here, we're thinking about that next step of, how do we enable real-world care? What does that look like? How do we partner with provider organizations, payers and teams working on digital identity and the big AI teams to help the average American not only have the ability to obtain information, but then to take the next step in managing their care," Agarwal said.

Another topic that is top of mind for providers: As patients engage with AI tools, there's an opportunity to share those conversations back with providers as a feedback loop. Those AI-based chats could give providers more insights about their patients' health after they have left the hospital or doctor's office, according to some provider executives who attended the roundtable.

"The reason that a lot of us are interested in patient-facing AI is because we're living in this moment where individuals want to have more control over their own health, and we know that our health system is overburdened and doesn't necessarily have the time and attention to give everyone as much as they would like," Oura's Bloomfield said. "Having tools that help people understand their health better is not just better for the consumer or for the patient, It's actually better for the health system as a whole to reduce the pressure that you have on clinicians that don't have enough time to see as many patients as they want."

"We actually see that as a solution to some of the problems in our health system today, especially around capacity and resourcing and burnout, is to really give these tools directly to patients," he noted.

By Heather Landi

Executive Editor

Fierce Healthcare