Why the 2028 shift to digital claim attachments may feel slower at first — but faster in the long run.
Starting in 2028, Centers for Medicare & Medicaid Services (CMS) will require digital claim attachments using standardized formats such as HL7 CDA, along with electronic signatures. At first glance, this looks like a straightforward upgrade: less fax, more automation, more structured documentation.
In reality, changes like this rarely feel simple at the beginning. Healthcare has already gone through a similar transformation — when paper charts were replaced by EHR systems.
When EHRs were first introduced, the expectation was clear: digitize records, improve access, and make workflows more efficient. What followed, however, was a period of disruption.
Workflows slowed down, documentation became heavier, and many clinicians felt that the systems added complexity rather than reducing it. In some organizations, productivity dropped, and teams relied on workarounds just to keep daily operations moving. At the time, it wasn’t obvious that the transition would succeed.
Over time, though, things began to stabilize. Data became easier to access and share, records stopped getting lost, and processes gradually became more predictable.
What initially felt like a burden turned into infrastructure. The improvement wasn’t immediate, but it was real.
The shift introduced by CMS-0053-F follows a similar pattern. While it is often described as a move away from fax, the more important change is happening at the level of data.
The mandate pushes healthcare organizations toward structured, standardized, machine-readable information. That requirement sounds technical, but in practice it affects everyday workflows.
Much of today’s clinical and administrative data is still unstructured or inconsistent. Even in widely used systems like Practice Fusion and ModMed, documentation often depends on free text, scanned files, and manual adjustments.
Structured formats such as HL7 CDA require a level of consistency that many workflows do not yet fully support.
Because of this, the initial impact of the transition may not be an immediate improvement.
Instead of missing documents, organizations may begin to see new types of issues — submissions that are technically received but cannot be processed due to format or data mismatches.
The friction does not disappear; it changes form.
Another important shift is where the work happens. In manual processes, effort is spent on sending documents, tracking submissions, and confirming receipt.
With structured data, more of that effort moves upstream — toward preparing data correctly, aligning documentation with requirements, and resolving validation issues before submission.
For many teams, especially smaller practices, this can feel like additional burden in the short term.
If the pattern follows EHR adoption, however, the long-term direction is different.
As workflows adjust and data becomes more consistent, submissions become more predictable, processing speeds improve, and administrative overhead begins to decrease.
Instead of chasing missing documents, teams work with data that can be tracked, validated, and reused across processes.
It is also unlikely that 2028 will be a clean “switch” from one system to another.
More realistically, the industry will move through a period of partial adoption, hybrid workflows, and gradual alignment. This is not a single moment of change, but an extended transition.
Healthcare has seen this cycle before: a new standard is introduced, resistance slows adoption, workflows become more complex before improving, and only over time do the benefits become clear.
EHR systems followed this path. Digital claim attachments are likely to follow it as well.
CMS-0053-F is often described as a technical upgrade. In practice, it is a shift toward structured data — and that kind of change is never immediate.
Like EHRs before it, it may slow things down at first, but over time, it has the potential to make processes faster, more consistent, and easier to manage.
Slower at first — faster in the long run.
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