VillageCareMAX earned second place in Flexpa's Nov 2025 State of The Payer Patient Access API report, with a Core Implementation score of 91 out of 100. The implementation uses Health Samurai's Aidbox FHIR platform.
This strong result positions VillageCareMAX as a leading U.S. health plan for both CMS-9115-F compliance and real-world API usability.
The report in context
Flexpa's Nov 2025 report evaluated 493 payers. VillageCareMAX scored 91/100 in Core Implementation, ranking second overall, just behind CMS (92) and ahead of various large national plans.
This continues a strong track record. In Flexpa's Nov 2024 report, Health Samurai was the top-performing vendor, with an average client score of 77 and the highest authorization success rates. Clients included Paramount Insurance Company, which tied for first among payers at 85 points.
Flexpa's real-world test
Flexpa evaluates more than basic compliance. Their testing measures real-world performance for patients and developers, assessing error handling, support response, and reliability. Their data reflects substantial ecosystem demand: over 428,000 patient authorization attempts and 100+ million FHIR resources synced.
Scores are based on:
Aidbox implementation at VillageCareMAX
VillageCareMAX selected Aidbox's certified FHIR API to meet the CMS-9115-F deadline of July 2021, a milestone that has been challenging for plans to achieve by the deadline. In Flexpa's 2024 State of Payer Patient Access APIs report, they ranked number one.
Today, they use the Aidbox FHIR Platform beyond compliance as a central data source for multiple applications.
The Aidbox FHIR Platform provides a full-featured backend: FHIR R4 storage aligned with CMS and CARIN guides, flexible profiling, built-in OAuth 2.0/SMART on FHIR security, and operational tools for logging and monitoring that help maintain high performance and low error rates.
Preparing for the next deadline: CMS-0057-F
The CMS Interoperability and Prior Authorization Final Rule (CMS-0057-F) has a January 1, 2027 deadline. Health plans with a robust, high-scoring Patient Access API are already ahead. Both rules share the same technical foundation (FHIR R4, OAuth 2.0), allowing for direct reuse of existing implementations.
How Health Samurai can help
The same Aidbox capabilities that power VillageCareMAX's top-ranking implementation are available to other health plans, payers, and developers needing to comply with CMS-9115-F and prepare for CMS-0057-F.
“VillageCareMAX is incredibly proud to be recognized as a top performer in Flexpa’s State of the Payer Patient Access API Report,” says Boyd Adolfsson, Deputy Chief Information Officer at VillageCare. “This achievement reflects our unwavering commitment to delivering secure, seamless, and patient centered access to health information. Our success would not have been possible without the outstanding collaboration of our technology partner, Health Samurai. Together, we’ve demonstrated what strong partnership and innovation can make possible for the communities we serve."
Health Samurai can provide a standardized FHIR layer, secure authentication flows, and implementation expertise to help your organization launch a usable, high-performing Patient Access API that meets both regulatory and real-world expectations.
Contact the Health Samurai team to discuss your implementation.
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HospitalonFHIR - FHIR Camp 2024 – Cascais/Lisbon 🌟 It was a great attending the FHIR Camp 2024, surrounded by passionate professionals and inspiring leaders in the healthcare interoperability space. It was truly an honor to learn from references like Grahame Grieve (and many more), alongside dedicated enthusiasts, all committed to advancing HL7 FHIR standards and fostering better healthcare systems worldwide.
Membro do conselho na E-Mais - Movimento Associação dos Sistemas de Informação Em Saúde
Had an amazing experience at the FHIR Camp 2024 organized by Health Samurai | Aidbox FHIR® Platform. Inspired by its transformative potential, I look forward to working further in FHIR and hope to see its implementation in Nepal's healthcare system as well.
Though a bit delayed but still I don’t want to miss out on talking about the recently concluded #FHIRCamp2024 organized by Health Samurai | Aidbox FHIR® Platform in the beautiful city of Cascais, Portugal.
Healthcare & Life-Sciences Consulting | HL7 FHIR® Expert | Digital Transformation Leader
I skipped a lot of recent conferences to prioritize attending FHIR Camp 2024 in Portugal the week before last. It was well worth the trip! It was great to hear Grahame Grieve give the background story on how FHIR came to be an open source effort. The open source angle is really important and unique in that it will require a lot of meaningful collaboration and perhaps unprecedented transparency (things we're not great at in the US) to advance these standards in the coming years. There is and will be a lot of opportunity for people to develop and offer FHIR expertise.
It was a pleasure to come to the #FHIR #camp in Cascais as a Hospitals on FHIR ambassador It was a pleasure to exchange our outlook on FHIR #versionning and how to deal with the multiple versions with Grahame Grieve, Lloyd McKenzie, Gino Canessa, Ewout Kramer and Nikolai Ryzhikov I also had the occasion to present the state of FHIR in #France and the work our community is doing to increase adoption And of course, always a pleasure to exchange with friends of the HL7 community.
FHIR interoperability expert and architect. CEO of Fyrstain. Hospitals On FHIR ambassador.
FHIR CAMP 2024 in Cascais, Portugal, was filled with excitement and activity. Here are some highlights that I'd love to share. This experience reflected the event's opening message: to connect systems and technologies, we must first connect with each other. It was an incredible day, and I can't wait to see what's next!
I'm back from the fantastic experience that was #FHIR Camp 2024 in Cascais, Portugal! I was grateful to reconnect with many of my long-time collaborators and also many new people that bring interesting perspectives that enhance our collective work. I really liked the format - I think it was very conducive to free-flowing conversation about new ideas and approaches. Thank you very much to Nikolai Ryzhikov, Pavel Smirnov and all of Health Samurai | Aidbox FHIR® Platform for the opportunity and the amazing support. I think the event was a great success!
I had the privilege of attending the FHIR® Camp 2024 🔥 in the beautiful Cascais, Lisbon 🇵🇹 hosted by Health Samurai | Aidbox FHIR® Platform The event brought together some of the brightest minds in the #HL7 #FHIR space, including industry pioneers like Grahame Grieve, Gino Canessa, Lloyd McKenzie, and many others! The sessions were not only inspiring but also directly relevant to the work we do at IgniteData.
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