The growing demand for interoperability and regulatory compliance in healthcare has made standardized data exchange a critical priority, particularly for submissions to the Centers for Medicare & Medicaid Services (CMS). This study explores the integration of Fast Healthcare Interoperability Resources (FHIR), Health Level Seven (HL7) standards, and modern data warehousing architectures to streamline CMS reporting workflows. While HL7 v2 and v3 have historically enabled clinical data exchange, their structural complexity and limited flexibility have constrained real-time analytics and large-scale regulatory reporting. FHIR, with its resource-based modular design and RESTful API capabilities, presents a more adaptable framework for harmonizing diverse healthcare datasets. This research proposes a unified architecture that bridges legacy HL7 messaging systems with FHIR-based APIs and centralized data warehouses. The approach focuses on transforming heterogeneous clinical, administrative, and claims data into standardized formats suitable for CMS quality reporting programs, including MIPS and value-based care initiatives. By incorporating Extract-Transform-Load (ETL) pipelines, sem
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