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:
- Core Implementation (100 pts): FHIR R4 compliance, SMART on FHIR/OAuth 2.0, essential data resources (Patient, Coverage, ExplanationOfBenefit), and API stability.
- Beyond Compliance (40 pts): Data completeness, clear documentation and errors, performance speed, support quality, and end-user experience.
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.
