Chair:  Viet Nguyen , Gay DolinGini McGlothin

Scribe: Linda Michaelsen
 

Attendees

Present

Name

Affiliation

  •  
Viet NguyenStratametrics
  •  
BCBS AL
  •  
Linda MichaelsenOptum
  •  
Namaste Informatics
  •  

  •  
Providence St. Joseph
  •  
NCQA
  •  
Chris JohnsonBCBS AL
  •  
BCBS AL
  •  
Dave FosterEdifecs
  •  
Grace StambaughVeradigm
  •  
BCBSM
  •  
Veradigm
  •  
Cigna
  •  
Cigna
  •  
Kamal TayalDrFirst
  •  
Leslie SmartHumana
  •  
Edifecs
  •  
Iris Health Solutions
  •  
CDC
  •  
Carradora
  •  

  •  
Peter Muir
  •  
Centene
  •  
MITRE
  •  
Optum
  •  
Optum
  •  
Availity
  •  
BCBS FL
  •  
Tom WillisMoxe Health
  •  
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
  •  
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
  •  
BCBSM
  •  
Matt AdamsonZeOmega
  •  
Steven BenjaminRegence
  •  
Epic
  •  
ZeOmega
  •  
Edifecs
  •  
Tibco
  •  
Intersystems
  •  
SachinZeOmega
  •  
Douglas Ansel
  •  
Joseph Bormei
  •  
Dynamic Health IT
  •  
Beverly BucktaPfizer
  •  
Jason RankinAthenahealth
  •  
Kenneth Salyards
  •  
NCQA
  •  
Dynamic Health IT
  •  
Telligen
  •  
Eric Thomas

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."


Agenda Topics

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 2:56pm ET

Supporting Documents

Outline Reference

Supporting Document

Minute ApprovalInsert Link to minutes here
Meeting Presentation Materials
Kick-Off Recording (11/21/19)Kick-off recording (11/21)


Action items