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|
|HL7 Process Update|
eVote still going on and ends this week.
CDS WG reviewed the PSS and are interested in this use case and would like to become an interested party and perhaps a co-sponsor. They would like to meet with us on Wed Q5 at the WGM.
Continue discussing Risk Adjustment Report data elements requirements from Payer to Provider and operation requirements
FHIR analysis discussion
Last discussion on the Initial Diagnosis state- we had thought to remove this, as it may not be required.
Start looking to see how to represent this in FHIR. Added new column in the report confluence page to list FHIR Analysis.
Patient- decide to see which of these US Core Patient, QI-Core Patient, ATR patient may work best.
Member ID- This comes through the Payers as identifier and would be mapped on the provider side.
HCC can come in within a 25 months period and can trickle in for a long time.
fyi, the current APIs for CMS, e.g. Blue Button ,BCDA, etc provide historical and current MBIs in the identifier element of the patient resource (for cases where the MBI has switched due to fraud, etc)
If MemberID is changed during the evaluation period, may need to know effective time of the memberID.
May need to review how CARIN Blue Button. CMS Blue button API (FHIR R3) does it, actually as an extension- codeable concept that says if code is historic or current)
this is the url for the extension: https://bluebutton.cms.gov/resources/codesystem/identifier-currency/
Cancel meeting 5/27/21 due to HL7 WGM.
|Adjournment||Adjourned at PM ET|
|Stratametrics||Dale Davidson||Rachel Foerster|
|Karl Everitt||Epic||Tim McNeil|
|BCBS Alabama||Thomson Kuhn||Leah Hannum|
|Providence St. Joseph||Patty Craig||Dave Foster|
|Phranil Metha||Healow||Cigna Evernorth|
|Brent Zenobia||Novillus||Travis Hendrix|
- 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.