hair:  Viet Nguyen, Yan Heras

Scribe: Phung Matthews
 

Minutes Approved as Presented 


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Agenda Topics

Agenda Outline

Agenda Item

Meeting Minutes from Discussion

Decision Link(if not child)
ManagementReview ANSI Anti-Trust Policy






Announcement

HL7 Connectathon 28 Sept 13-15 

  • Registration is now available here
  • Last day to register is August 30th. 
  • Plan to hold a Risk Adjustment Track!

Visit the Da Vinci HL7 Connectathon page for quick highlights on each tracks. 



Risk Adjustment IGContinuous Integration (CI) Build site: https://build.fhir.org/ig/HL7/davinci-ra

IG development progress

Drafting content and welcome your contribution- please reach out if you are interested. 

Examples are being placed in the example tab

Glossary page - adding all the definitions used for this IG

Question- Coverage report- we do not have anything pointing to the coverage resource.

  • should we have an element or extension from the measure report?



Discussion

Continue with business requirement and FHIR analysis discussion:

$report operation

In previous markup- we included suspect type and evidence status as parameters but is being removed.

Discussion were to have everything returned and then allow filtering before it goes back to the provider

Examples

Currently have couple examples in the link, narrative version, xml version, 

Walking through one example- the narrative portion lays out the example of HCC codes and the xml version lays out the FHIR resources 

  • Code- has codeable concept - 
    • has system and version
    • but since HCC is not like other terminology that has a url that can be referenced. instead for CMS, they publish several versions and do not have one specific place to pull that information. 
    • currently put in a temporary URL but will reach out to terminology WG to seek feedback
  • CMS model - provides HCC code, may be a lag on the release of the code
  • Looking to have an identifier to indicate it is a CMS HCC- maybe check with CMS to have unique identifier?
  • Value set authority- under National Library of Medicine 
  • each measure has different authority that is responsible for the measure codes 
  • We could define our own internal list for the example

Question- 

If there will an option to specify ICD10 code, especially when the HCC is in confirmed status.

Yes- we have the extension of historic diagnosis that can be used. Can only use it if it is confirmed


Connectathon Planning

Draft agenda will be in Whova

September 9th meeting for the Pre-connectathon kick off

Will start on Tuesday 9/14/21

Will dive into development and testing. It will be more hands on and testing at same time. 

Proposed test cases- thanks Brent for starting this. 

  • would like to test evidence status, suspect type, subject and model/version



Viet Nguyen to Everyone

@Brian - We terminologists make a distinction between 1) The code system (e.g. SNOMED-CT) which has an authority for creating, depricating, maintaining the code system 2) A value set, which can be a set small set of codes (like the HL7 Administrative Gender codes) or a set of codes from a Code System 3) VSAC - which is a repository that we can point to an OID which represents a value set

Ideally, CMS would be the authority for the HCC codes and value sets and agrees to publish them to VSAC on a schedule. That would allow us to point to the OID

For large code systems, groups (like NCQA) can create a value set based on the code system (like all the children of the SNOMED Diabetes concept code). They may or may not list the valueset in VSAC depending on the use case.

More details are available at http://hl7.org/fhir/terminology-module.html

Madhurima Dhar (COZEVA) to Everyone

What is the different between unconfirmed vs pending?


ManagementNext Agenda



Adjournment
adjourned at 03:58PM ET

Attendees

Present

Name

Affiliation


PresentNameAffiliation
PresentNameAffiliation
PresentNameAffiliation
  •  
Viet Nguyen
Stratametrics
  •  
Dale Davidson

  •  
Rachel Foerster

  •  
Kimberly Bradbury
  •  

Yan Heras



  •  
Karl EverittEpic
  •  
Tim McNeil




  •  
Gini McGlothin
BCBS Alabama
  •  
Thomson Kuhn

  •  
Leah Hannum




  •  
John Graham
Providence St. Joseph
  •  
Patty Craig

  •  
Dave Foster




  •  

Peter Muir



  •  
Nick Radov

  •  
Bryan Briegel




  •  

Linda Michaelsen

Optum
  •  
William Harty

  •  
Preston Lee




  •  

Brian Murta

Centene
  •  
Deidre Sacra

  •  
Gary Dickinson




  •  

Phung Matthews

POCP
  •  
Jay Baker

  •  
Rob Reynolds




  •  

Vanessa Candelora

POCP
  •  
Joseph QuinnHSX
  •  
Shawn




  •  
Phranil MethaHealow
  •  

Ezequiel Morales

Cigna Evernorth
  •  
Donielle Williams




  •  
Anna Taylor
MultiCare
  •  
Mariel Brechner

  •  

Khush Singh






  •  
Susan Langford
BCBST
  •  
Christopher Marchand

  •  
Pranathi K




  •  
Floyd Eisenberg


  •  
Madhurima DharCozeva
  •  
Vijay Sravani Thotakura




  •  
Susan Bellile
Availity
  •  
Kira Whitworth

  •  
Angie Finley




  •  
Brent ZenobiaNovillus
  •  
Travis Hendrix

  •  
Eric Liu




  •  
Amy Neftzger
Optum
  •  
Zahid Butt

  •  
Kim Faison




  •  
Frank

  •  
Khushwinder Singh

  •  
Tushar Shah





Action items

  •  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.

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