CMS marks one year of its Health Tech Ecosystem with eight new pledge categories and a "RIP Clipboard" moment

A Spirit Halloween-style coffin labeled "RIP CLIPBOARD" was carried onstage at Health and Human Services headquarters on July 28, 2026. It was a deliberate bit of theater, but the message from the Centers for Medicare & Medicaid Services was concrete: one year into its Health Tech Ecosystem initiative, CMS is pushing to replace paper-based patient intake with interoperable digital infrastructure, and it is expanding the program with eight new pledge categories to get there.

The anniversary event, reported by STAT, doubled as a progress review and a recruitment drive. Federal Medicare official Zac Jiwa led the clipboard ceremony, framing the decades-old waiting-room staple as a casualty of the digital systems that pledge companies have spent the past year building, covering everything from health information exchange networks and electronic health records to patient-facing apps, according to STAT.

A voluntary framework, not a new regulation

CMS has been deliberate about the initiative's non-regulatory character from the start. The agency's overview page describes the Health Tech Ecosystem as "a movement, not a mandate," and explicitly states that nothing in the framework is intended to supersede or preempt existing federal or state healthcare privacy laws, including HIPAA and the Privacy Act of 1974. That framing matters for enterprise compliance teams: participation is optional, but the agency is betting that early movers will shape the standards that eventually become table stakes.

Amy Gleason, who leads the Health Tech Ecosystem within CMS, has been the public face of the initiative. The framework asks EHR systems, health app developers, payers, data networks, and providers to voluntarily align around shared standards for data access and interoperability. CMS, for its part, has committed to building public infrastructure to support that alignment, including a National Provider Directory and modern identity capabilities on Medicare.gov, according to the agency's overview.

Eight new pledge categories expand the ecosystem's scope

The original launch, held at a White House event in 2025 under the banner "Make Health Tech Great Again," drew commitments from major healthcare and IT firms across a defined set of ecosystem categories. STAT reported that CMS used the one-year anniversary to announce eight new pledge categories, broadening the surface area of the voluntary framework. The agency also published a Pledge Demo Showcase, where participating companies demonstrated working implementations of their commitments.

The ecosystem's structure organizes private-sector participation around clearly defined categories designed to align common infrastructure with innovation. On the public-infrastructure side, CMS has been building out an interoperability framework focused on provider and payer directory data. Companies looking to join can submit a pledge form directly through the CMS site, and a list of early adopters across all pledge categories is publicly available.

The Medicare App Library is another new component added since the initiative's launch. CMS is calling on health app developers to align with shared data standards so that Medicare beneficiaries can access their health information through third-party applications. For health IT vendors and app developers, the library represents both a distribution channel and a signal of where Medicare's digital front door is heading.

What enterprise health IT and procurement teams should watch

For CIOs and procurement leaders at health systems, the practical question is where the eight new pledge categories land relative to their existing technology stack. The initiative targets the same integration points that enterprise health IT teams already manage: EHR connectivity, patient identity, data exchange with payers, and app access to claims and clinical data. Voluntary alignment today could reduce friction if those standards harden into regulatory requirements later.

CMS has signaled it expects real, live deliverables from participating companies before the end of 2026, according to the agency's overview. That timeline compresses the evaluation window. Health IT leaders evaluating EHR upgrades, patient-intake modernization projects, or third-party app integrations should check whether their vendor has signed on as a pledge company and, if so, what specific commitments are on the table.

For context on how broadly CMS is casting the net, the agency has published a CMS AI Playbook as a companion resource, and conducted a formal Request for Information published in the Federal Register in May 2025 to gather public input before expanding the framework. The eight new categories announced in July 2026 reflect what the agency heard from that input process. A full list of early adopters is on the CMS website; the next concrete milestone is the end-of-year delivery checkpoint the agency has set for current pledge participants.