Updated October 26, 2026
· ~1 min read
FHIR is now the required interface for payer APIs under CMS-0057-F and the common language of EHR integration. All three options store and serve FHIR R4 resources. They differ in who operates them, how far you can change them, and what comes built in around the server.
Question 1 of 2
Is FHIR mainly an API and data store you must provide, such as CMS-0057-F payer APIs?
**AWS HealthLake:** the least to operate, under your AWS BAA, with SMART on FHIR, bulk export and medical NLP built in. Fits payers and analytics teams that want FHIR as a managed data store. Less room to customize server behaviour. **HAPI FHIR:** the most control and no licence cost: the reference open-source server, run on ECS or EKS with Aurora PostgreSQL. Fits teams with Java skills that need custom operations or validation. You own upgrades, scaling and security. **Medplum:** a developer platform around FHIR (auth, bots, a React component library, integrations) for teams building clinical applications. Open source, hosted or self-hosted. Adds the most application tooling; hosted plans cost the most at small scale.
CMS-0057-F Payer APIs on AWS
Medicare Advantage, Medicaid, CHIP and federal-exchange QHP payers need Patient Access, Provider Access, Payer-to-Payer and Prior Authorization APIs by January 1, 2027. We build them on AWS with HealthLake or a FHIR server, map your claims and clinical data to the required profiles, and wire prior authorization to your UM system.
HIPAA-Ready AWS Environment
Implement the AWS controls required for HIPAA compliance, before the auditor asks.
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As of October 26, 2026. Provided as is, for general information, and accurate to the best of our knowledge on the date shown. Not legal, compliance, tax, financial or other professional advice. Prices, limits and vendor services change; check current vendor documentation before relying on anything here. Terms of use.