Chair: Viet Nguyen, Yan Heras
Scribe: Phung Matthews
Minutes Approved as Presented
This is to approve minutes via general consent. "You have received the minutes. Are there any corrections to the minutes? (pause) Hearing none, if there are no objections, the minutes are approved as printed."
Meeting Minutes from Discussion
|Decision Link(if not child)|
|Management||Review ANSI Anti-Trust Policy|
Da Vinci FHIR Education and Implementation event
April 26th- April 30th
|HL7 Process Update|
Patient Care will be an interested party rather than a co-sponsor.
If we need more clinical input, we can bring it back to Patient Care to request for co-sponsor.
We will take it to next HL7 process.
1) Risk Adjustment to Calculate Capitated Premium Payment vs. Risk Adjustment in Quality Measurement
2) Discuss Risk Adjustment Report data elements and structural requirements from Payer to Provider
Name of IG
Updated terms of risk to include further specific based on last week discussion.
PSS title and IG title does not need to match fully.
Risk Adjustment Report
Review Risk Adjustment Report data elements table. See link.
Determine if we have all data elements, place hierachical
lastClaim- does this need to be placed for each HCC code?
Note- Public calls for the Week of 4/26-4/30/21 will be cancelled due to Da Vinci Education Event.
|Adjournment||Adjourned at 03:57 PM ET|
|BCBS Alabama||Thomson Kuhn|
|Providence St. Joseph||Patty Craig|
- Re-evaluate the name of this use case as "Risk Adjustment" does not define the payment aspect of the primary focus. Need to discuss with CQI WG as well.
- Add to Phase 2 - Ability to remove and provide a reason for status change. e.g. the patient no longer has the condition.