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Present

Name

Affiliation

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Viet NguyenStratametrics
  •   
BCBS AL
  •   
Linda MichaelsenOptum
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Namaste Informatics
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  •   
Providence St. Joseph
  •   
NCQA
  •   
Chris JohnsonBCBS AL
  •   
BCBS AL
  •   
Dave FosterEdifecs
  •   
Grace StambaughVeradigm
  •   
BCBSM
  •   
Veradigm
  •   
Cigna
  •   
Cigna
  •   
Kamal TayalDrFirst
  •   
Leslie SmartHumana
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Edifecs
  •   
Iris Health Solutions
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CDC
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Carradora
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  •   
Peter Muir
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Centene
  •   
MITRE
  •   
Optum
  •   
Optum
  •   
Availity
  •   
BCBS FL
  •   
Tom WillisMoxe Health
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Express Scripts
  •   
Cindy MonarchBCBSM
  •   
Eric Haas
  •   
Jason TeepleCigna
  •   
Cigna
  •   
Diameter Health
  •   
Andrea KentCoverMyMeds
  •   
Bob HarringtonAllscripts
  •   
Anthem
  •   
Independent Health
  •   
eClinicalWorks
  •   
ZeOmega
  •   
UHC
  •   
Epic
  •   
Bart CarlsonAzuba Health
  •   
Edward CastagnaAltarum
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Cigna
  •   
Humana
  •   
Rachel E. FoersterCAQH Core
  •   
Ryan WeberUHC
  •   
Sandy BeggsIBC
  •   
Optum
  •   
BCBST
  •   
Sutter Health
  •   
Chuck GalliIBC
  •   
iParsimony
  •   
Sreekanth
  •   
WPS Health Solutions
  •   
eClinicalWorks
  •   
Dani Hochleutner
  •   
ZeOmega
  •   
Christopher MarchandDiameter Health
  •   
Joe Bormel
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BCBSM
  •   
Matt AdamsonZeOmega
  •   
Steven BenjaminRegence
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Epic
  •   
ZeOmega
  •   
Edifecs
  •   
Tibco
  •   
Intersystems
  •   
SachinZeOmega
  •   
Douglas Ansel
  •   
Joseph Bormei
  •   
  •   
Raychell FernandezDynamic Health IT
  •   
Beverly BucktaPfizer
  •   
Jason RankinAthenahealth
  •   
Kenneth Salyards
  •  
NCQA
  •  
Dynamic Health IT
  •  
University of Iowa
  •  
Eric Thomas

Minutes Approved as Presented 

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Agenda Outline

Agenda Item

Meeting Minutes from Discussion

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



Patient List Measure Report
  • Providers would want list of patients who don't have any concerns according to the payer, and then details of the ones who do
    • As a provider, I'd want to know who did you evaluate?
    • If you tell provider who insurer evaluated, provider can say these people are missing from the list - maybe they still have gaps
    • Interested in receiving attributed list, not just the patients of concern who have gaps
  • Need all patients, specific measures you're looking at, and last date of compliance
    • Depends what you're trying to accomplish
    • Sometimes problem is in attribution list
    • Sometimes problem is who has the latest information
      • Often provider has the information and the payer may not
      • Patient may get a service without the PCP knowing, and the payer will have that information and provider may not
      • If doing electronic reconciliation between the 2, the report could be different - but underlying data set on both sides need: attribution list, patient identification, measure, date of last compliance (and what was the compliance)
    • Provider may wish to know gaps that are going to expire in next 30-60 days, or might be chasing previous numbers - it may depend on where you are in the calendar year
  • If we are talking about information transfer between provider/payers - database level of information, not a report that gets printed and handed to provider
    • Use of data is one purpose
    • Use of report is a different purpose
  • A separate Da Vinci Implementation Guide addresses member attribution list - Risk Based Contract Member Identification
  • Dana Marcelonis wil reach out to Member ID team to see if someone is available to present an overview of IG, or if we have a recording of an overview that this group can access
  • List Resource for Measure List Report
  • GIC IG - need to finalize whether it's going to be part of the existing DEQM IG

Topics for Future meetings


ManagementNext Agenda

Adjournment
Adjourned at at 2:56pm ET

Supporting Documents

Outline Reference

Supporting Document

Minute Approval
Meeting Presentation Materials
Kick-Off Recording (11/21/19)Kick-off recording (11/21)

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