WEDI Newsletter  |  June 2017
Executive Corner | Prior Authorization Discussion Heating Up
Media Spotlight: WEDI Featured in HIE Answers
New WEDI Vimeo Channel Launched |  Workgroup Roundup
Sponsorship Special | Latest Member News
Each month, the Executive Corner provides prominent WEDI leaders an opportunity to share their perspectives on a variety of topics impacting healthcare – from legislative matters and industry events to the headline-grabbing issues of the day.  
Dear Members of WEDI,

As the summer days heat up, so is WEDI’s programming! Sure, we just wrapped up a successful annual conference in Hollywood where some of the biggest names in our industry gathered to share their thoughts on the driving forces shaping the healthcare landscape. But that was just the start…

I’m proud to announce that Donald W. Rucker, MD, head of the Office of the National Coordinator for Health Information Technology, will deliver the keynote at our upcoming 2017 Summer Forum. Held this August 1-2 in Chicago, the Forum will address inefficient administrative processes and the potential solutions to mitigate them.

Having Dr. Rucker share his valuable insights will be a critical addition to the program as the former practicing emergency department physician in several of the nation’s top health systems brings a rare combination of real-world business and clinical experience, as well as a comprehensive knowledge of health information technology.

Aside from Dr. Rucker’s keynote, our forum will include a session with Madhu Annadata, director, Division of National Standards, Centers for Medicare & Medicaid Services (CMS). These industry leaders will highlight an agenda packed with two days of high-level discussions focused not just on the burdens prior authorization and other transaction policies pose, but, more importantly, potential solutions the industry can implement to address these hurdles.

The first day of the Forum will focus on critically important industry issues regarding prior authorization including addressing the disconnect between payer EDI and medical systems; improving the current burdensome prior authorization process in the medical services, pharmacy, dental, and workers compensation sectors; and reviewing prior authorization and utilization management reform principles.

Day Two will target recent developments in healthcare policy under the new administration, as well as looking ahead at forthcoming federal administrative regulations that are expected to impact the industry and answers to several regulatory issues that CMS will be addressing on prior authorization, attachments, and other pending decisions.

With so much change happening in our industry, we hope you can all join us this August in Chicago for our 2017 Summer Forum !

– Charles W. Stellar, WEDI president and CEO 

With the topic of prior authorization continuing to make headlines as physicians grow increasingly frustrated by the hurdles facing patients seeking care, healthcare leaders will come together at our Summer Forum to address prior authorization and other administrative inefficiencies.

Earlier this year, WEDI President and CEO Charles W. Stellar joined a panel session at the 2017 HIMSS Annual Convention and Exhibition to discuss prior authorization pain points and how healthcare organizations need to engage in dialogue in order to help lessen payer and provider frustrations. During the session, Stellar announced that WEDI will facilitate a Prior Authorization Council which will focus on bringing payers and providers together to not only discuss reform but bring feedback on the topic to industry change agents who can help implement the Council’s recommendations.

The conversation continued at last month’s WEDI 2017 in Los Angeles where attendees actively participated in conversations surrounding critical topics, including prior authorization, shaping the healthcare landscape.

Although a focus all year long, the discussion surrounding prior authorization is not new to WEDI as a workgroup was formed last year to evaluate barriers, business cases, current workflows, and return-on-investment related to prior authorization.Co-chaired by representatives from Aetna, the American Medical Association, and Change Healthcare, the group looks to foster enhanced collaboration between payers and providers and support prior authorization processes being performed with a focus on increased value, automation and efficiency.

Learn more about WEDI’s Prior Authorization and other workgroups at www.wedi.org.

Last month, WEDI presented testimony before the Department of Health and Human Services, National Committee on Vital and Health Statistics (NCVHS), Subcommittee on Standards. HIE Answers, the community network site dedicated to educating healthcare providers and other stakeholders on the advancement of health information exchange, interoperability and federal initiatives to adopt HIT standards, recently featured WEDI and our testimony.

For the full article from HIE Answers, click here.

Recorded straight from Hollywood during last month’s WEDI 2017, we’ve uploaded the video: WEDI Helps Stakeholders Make a Difference in Healthcare to our newly launched Vimeo channel. There will be several more on the way, so be sure to check in periodically for new additions to the channel!

All of our workgroups have great projects and things underway, here’s just a brief highlight of a few:

  • The Innovative Encounters Workgroup is continuing its development of the Telehealth Modalities Issue Brief. The brief explores many of the different types of modalities available for use in telehealth as well as acknowledging the uses and limitations of the modalities.
  • The Privacy and Security Workgroup is starting work on developing comprehensive guidance on Privacy and Security training programs as required by the HIPAA regulations.  The workgroup is striving to develop an Issue Brief and Webinar covering key requirements that need to be a part of an organization’s training package if they are a covered entity versus a business associate.  As an outline for material is being constructed, the co-chairs are encouraging WEDI constituents to become involved in the development process.  The overall goal is for multiple parties in the healthcare industry to gain a more comprehensive understanding of what an organization will need in a training initiative to meet regulatory requirements.
  • The Dental Subworkgroup continues its effort to provide its white paper bringing the X12 005010 837D transaction cross reference and mapping information current with the 2012 ADA Claim Form.  We also reviewed the X12 007030 837D Transaction during the X12 Public Comment Period.  We will also be sending speaker representatives to the WEDI Summer Forum addressing dental processing for Prior Authorization submission.
WEDI offers numerous advertising, marketing and sponsorship opportunities allowing your organization to market to your specific healthcare audience. Our sponsorships fit a wide range of marketing strategies, promotional methods and budgets. One such opportunity currently available at our special promotion price is the Refreshment Break Sponsorship for the discounted price of $3,500. The sponsorship is available for both the Summer Form and WEDI-Con 2017. Act now to take advantage of this deal!
There are also many sponsorship opportunities at each of our major on-site
conferences as well as virtual conferences and webinars, or sponsorship of
educational materials such as white papers and issue briefs. Contact us today at businessdevelopment@wedi.org to decide which opportunity is right for you!
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The Workgroup for Electronic Data Interchange (WEDI) is the leading authority on the use of health IT to improve healthcare information exchange in order to enhance the quality of care, improve efficiency and to reduce costs of the American healthcare system. Formed in 1991 by the Secretary of Health and Human Services (HHS), WEDI was named in the 1996 HIPAA legislation as an advisor to HHS and continues to fulfill that role today.
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