specification: FinOps Framework
specificationVersion: '1.0'
schema: https://www.finops.org/framework/
provider: CMS Blue Button 2.0
providerId: cms-blue-button
created: '2026-07-11'
modified: '2026-07-11'
reconciled: false
tags:
- Blue Button
- CARIN
- Medicare
- FHIR
- Claims Data
- FinOps
- Cost Management
- FOCUS
description: >-
  FinOps view of Blue Button 2.0 spend. The API is a free U.S. government
  service operated by the Centers for Medicare & Medicaid Services - there is
  no invoice from CMS at any usage level, in sandbox or production. The real
  costs of consuming Blue Button 2.0 sit on the consumer side - engineering
  time to pass CMS production approval (privacy policy, terms of service,
  demo), infrastructure to run the OAuth consent flow and store
  beneficiary-consented FHIR data, and the compliance overhead of handling
  Medicare claims data (breach notification, dormant-account, and third-party
  vendor obligations from the CMS terms).
notes: >-
  There are no vendor charge categories to track. Model internal costs
  instead - per-beneficiary storage and sync compute grow linearly with
  authorized users, and token lifecycles (1-hour access tokens, one-time-use
  refresh tokens) shape polling architecture and compute cost.
sources:
- https://bluebutton.cms.gov/
- https://bluebutton.cms.gov/production-access/
- https://bluebutton.cms.gov/terms/
- https://focus.finops.org/focus-specification/v1-3/
alignedWith:
  framework: FinOps Foundation Framework
  frameworkUrl: https://www.finops.org/framework/
  dataSpec: FOCUS
  dataSpecVersion: '1.3'
  dataSpecUrl: https://focus.finops.org/focus-specification/v1-3/
publisherName: Centers for Medicare & Medicaid Services
serviceCategory: Healthcare Data
billingModel:
  pricingCategory: Free
  billingFrequency: None
  billingCurrency: USD
  chargeCategories: []
focusColumns:
  ServiceName: Blue Button 2.0
  ServiceCategory: Healthcare Data
  ProviderName: Centers for Medicare & Medicaid Services
  PublisherName: Centers for Medicare & Medicaid Services
  InvoiceIssuerName: None (free government service)
  BillingCurrency: USD
  ChargeCategory: None
  PricingCategory: Free
meters:
- name: authorized_beneficiaries
  description: Number of Medicare beneficiaries who have authorized the application; drives consumer-side storage and sync compute, not a CMS charge.
  unit: users
  aggregation: sum
  dimensions:
  - application
- name: fhir_requests
  description: FHIR API requests to ExplanationOfBenefit, Patient, and Coverage endpoints; free, but drives consumer-side compute and polling architecture.
  unit: requests
  aggregation: sum
  dimensions:
  - application
  - resource
- name: token_refreshes
  description: OAuth token grants and refreshes; one-hour access tokens and one-time-use refresh tokens shape sync scheduling.
  unit: tokens
  aggregation: sum
  dimensions:
  - application
- name: compliance_overhead
  description: Internal cost of meeting CMS terms - privacy policy upkeep, breach notification readiness, dormant-account handling, vendor reviews.
  unit: hours
  aggregation: sum
  dimensions:
  - application
principles:
- name: Visibility
  description: Track authorized-beneficiary counts and per-resource request volume even though CMS never bills; they are the drivers of your own infrastructure cost.
- name: Allocation
  description: Attribute storage, sync compute, and compliance overhead per product or team consuming Medicare claims data.
- name: Optimization
  description: Poll incrementally with _lastUpdated and page with _count to minimize compute; avoid re-pulling full multi-year claim histories.
- name: Accountability
  description: Assign an owner for CMS terms-of-service compliance and for the production-approval relationship with the Blue Button team.
maintainers:
- FN: Kin Lane
  email: kin@apievangelist.com