WEDI Offers Public Comments on TEFCA Draft 2
WEDI Offers Public Comments on CMS and ONC Proposed Rules
CMS, WEDI and CAQH CORE Webinar Series
Upcoming WEDI Webinars | Workgroup Roundup
WEDI Welcomes New Members | Media Spotlight
Featured Video on Demand | Latest Member News | HLTH Discount Code
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On the heels of the Spring Conference, and with just one month left until our Summer Forum, I’d like to thank our Educational Committee and Board for their ongoing efforts to ensure WEDI events continue to be the enlightening educational resources they are known to be. I hope to see our members and many new faces in Chicago as we continue the conversation on the importance of joining forces to improve health information exchange. We strive to tailor these events to our membership, and we are honored to have your support to make these events highly educational and successful.
There is no shortage of activity at WEDI. In this newsletter edition, you’ll see that we have a remarkable list of upcoming webinars, including the CMS, WEDI and CAQH CORE Webinar Series. Our many Workgroups are dedicated to continuing their collaborative efforts in adding value to the industry through the creation of webinars, surveys, white papers and more.
If you have any questions or would like to find out more on how to be involved in joining our Workgroups and Subworkgroups, please feel free to contact us. We are always looking for leaders willing to share expertise and continue the mission of WEDI.
Looking forward to meeting you in Chicago!
Charles Stellar
WEDI President & CEO
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WEDI’s 2019 Summer Forum:
Bridging EDI to API – Working for Today, Preparing for Tomorrow
is less than one month away. You will not want to miss this premiere event which will provide attendees with the opportunity to ask questions and offer thoughts on some of the most important issues in health IT and interoperability.
Key sessions will include:
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New Technological Mandates
Tuesday, July 30, 8:30-9:30 a.m.
Steve Posnack, Executive Director, Office of Technology, ONC will explain the implications of the ONC NPRM regarding the specific technology that will be required to support the easy flow of patient info between provider, payers, members and other key stakeholders.
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Consumers at the Center: How Open Data,
APIs and Value-Based Payment Can Fuel
a Better Delivery System
Wednesday, July 31, 12:45-1:30 p.m.
Aneesh Chopra, President, CareJourney and the first US Chief Technology Officer will explore how giving the patient the opportunity to own/possess all their health information in a digital format changes the nature of the interoperability problem. When the patient can make their information available to whom they want, when they want,
then many of the issues currently associated with getting
the other stakeholders to share go away.
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Other timely topics include:
- EDI to API: Compare and Contrast
- Innovations in Connectivity: From SFTP to REST
- Payer Data Sharing: Payer-to-Payer and Payer-to-Member
- Payer-Provider Data Exchange – Going Beyond HIPAA
- New Technology – How the Standards Work Together
- State of Prior Authorization
- Payer Initiatives using Prior Authorization and Attachments
- Deep Dive on a Workflow for the 278, Attachments and FHIR working together
Join us in continuing WEDI’s mission to improve health information exchange – enhancing quality of care, improving efficiency and reducing cost. WEDI 2019 Summer Forum is open to all interested healthcare stakeholders across provider, payer, vendor and government entities.
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Earlier this month, WEDI announced the submission of recommendations to Don Rucker, M.D., National Coordinator for Health Information Technology, Office of the National Coordinator for Health Information Technology (ONC) pertaining to the Trusted Exchange Framework and Common Agreement (TEFCA) Draft 2. Following the submission, WEDI issued the following statement on behalf of Jay Eisenstock, Chair, WEDI Board of Directors:
“As ONC further develops their approach to advancing interoperability, we encourage the collaboration with the Centers for Medicare & Medicaid Services (CMS), as well as industry stakeholders such as WEDI. As a multi‐stakeholder organization comprised of health plans, providers, vendors and SDOs, WEDI offers the structure for intra‐industry collaboration. WEDI has proven leadership engaging the industry to address the most impactful changes of our time, including the National Provider Identifier, ICD‐10, health claim attachments and prior authorization.
Within the statement, WEDI focused its comments on those provisions specifically of interest to its membership. In addition to the specific regulatory, operational and tactical recommendations, WEDI offered the following general recommendations:
- WEDI supports the intent of the Trusted Exchange Framework and Common Agreement, however encourages ONC to ensure adequate industry notification of comment opportunities related to TEFCA. Formal regulatory comment periods are announced through the Federal Register and WEDI suggests a similar approach to ensure that all materially affected parties are aware of the opportunity to comment.
- WEDI encourages ONC to ensure there is adequate time for the health care industry to modify contracts and business associate agreements as well as notices of privacy practices. Ensuring the industry has the ability to implement all of these pieces, as well as any new agreements and documents needed, is critical to the overall goals of interoperability.
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WEDI recently announced the submission of recommendations to the Centers for Medicare & Medicaid Services’ (CMS) and the Office of the National Coordinator (ONC) for Health Information Technology pertaining to the proposed rules implementing provisions in the 21
st
Century Cures Act. Following the submissions, WEDI issued the following statement on behalf of Jay Eisenstock, Chair, WEDI Board of Directors:
“We want to commend the Centers for Medicare & Medicaid Services for the work undertaken to advance the interoperability of electronic health information. The 21st Century Cures Act pushed the issues of information blocking and lack of interoperability to the forefront of the industry and this proposed rule is a step towards addressing these issues. Although we support CMS in their effort to advance interoperability, WEDI feels – in concert with other health industry groups – that as proposed, the 24‐month timeline would be insufficient to allow for provider adoption and implementation and EHR vendor development.
“As CMS further develops their approach to advancing interoperability, we encourage the collaboration with the Office of the National Coordinator for Health Information Technology, as well as industry stakeholders such as WEDI.
“As an advisor to the Secretary of the Department of Health and Human Services and a multi-stakeholder organization comprised of health plans, providers, vendors and SDOs, WEDI offers the structure for intra‐industry collaboration. WEDI has proven leadership engaging the industry to address the most impactful changes of our time, including the National Provider Identifier, ICD‐10, health claim attachments and prior authorization. WEDI supports this proposed rule, which is CMS’ initial phase to advance interoperability across the United States health care system, and specifically within the Medicare and Medicaid programs, the Children’s Health Insurance Program (CHIP) and issuers of qualified health plans (QHPs).”
On ONC’s proposed rule on Interoperability, Information Blocking, and the ONC Health IT Certification Program, Eisenstock added:
“As ONC further develops their approach to advancing interoperability, we encourage the collaboration with the Centers for Medicare & Medicaid Services, as well as industry stakeholders such as WEDI. We applaud ONC’s initial phase to advance interoperability across the United States (U.S.) health care system in support of the access, exchange and use of electronic health information and encourage ONC refinements to the rule as offered in our submitted comments.”
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CMS, WEDI and CAQH CORE Webinar Series:
Part 2 – CMS Compliance Reviews
Thursday, July 18, 2019 | 2:00 - 3:00 pm ET
In the second webinar of a two-part summer collaboration between the CMS, WEDI and CAQH CORE, the CMS Division of National Standards will provide an overview of the Compliance Review Program
to ensure conformity among covered entities with HIPAA Administrative Simplification rules for electronic health care transactions.
Webinar Highlights:
- A review of the Compliance Review Program process to ensure compliance among covered entities with HIPAA Administrative Simplification requirements.
- Overview of Corrective Action Plans in the event of noncompliance.
- Results of the HHS Optimization Pilot.
- A call for participation in the voluntary pilot program for providers.
Presenter
Paul Anderson, Health Insurance Specialist, CMS Division of National Standards
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Alternative Payment Models and Risk-Bearing
Wednesday, July 10, 2019 (3:00-4:00 p.m. ET)
In the early 1970s, David Bowie released the song
Changes
telling the world to “turn and face the strange.” Easier said than done. The new millennium has brought on rapid change in the way care is delivered, reimbursed and measured. Value in healthcare is now measured by the health status of patient populations. More and more, alternative payment models (APMs) are requiring providers to think beyond their individual patient populations to community-wide consumers of their services under risk-bearing arrangements. Health plans have been in the community-based risk management business for decades. As the payment paradigm moves risk to provider communities, the role of community-wide risk management becomes more essential to providers. Join us as we examine the 4 most common barriers to success as payers and providers share in patient risk.
By the end of the presentation, attendees will be able to:
- Identify alternative payment model (APM) archetypes and operational considerations.
- List the four considerations to successful risk-bearing contracts.
- Formulate strategies for rational risk-bearing that contemplates alignment of payer measures through an alternative payment model.
A certificate of education is available for this webinar. WEDI is hosting this webinar
FREE
for members, and non-members are also welcome to attend for a cost of
$199
.
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Clearing a Path to Innovation in Clinical Genomics
for Health Insurers
Tuesday, July 16, 2019 (3:00-4:00 p.m. ET)
Genomics is the study of the entirety of our DNA, and Genomic Medicine is its application to clinical care. But there are a wide range of genomic information exchange issues – including genomic data formats and system interoperability, the storage, management, and governance of large data sets, privacy and security controls, care coordination and payer-provider collaboration.
This webinar will cover the state of clinical genomics today from a cross-industry perspective and explore next steps in identifying opportunities for innovation, both in the near term and long range. This will include a discussion of priorities, like standardization and what does the insurer industry really need.
WEDI is hosting this webinar
FREE
for members, and non-members are also welcome to attend for a cost of
$199
.
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All of our workgroups have special projects and activities underway, here’s just a brief highlight of a few:
- The Privacy & Security Workgroup submitted comments in response to ONC's TECFA proposals. The Workgroup is currently working on scheduling sessions at the Summer Forum, with a specific focus on timely privacy and security topics.
- The Remittance Advice and Payment Subworkgroup has published a paper on Provider Adjustments (PLB) in the Electronic Remittance Advice (835), including information on best practices for reporting interest and prompt pay discounts. The SWG is now working on updates to the paper to outline best practices for the OverPayment Recovery and Balance Forward process.
- The Payment Models Workgroup conducted a value-based payment (VBP) interactive session during the WEDI Spring Conference that was attended by nearly 60 diversely positioned stakeholders. To obtain a wide array of point-of-views, attendees were asked to identify the top 3 priorities for 7 domains necessary to achieve value in healthcare, namely: financing modernization, consumer engagement, purchaser alignment, alternative payment administration, data interoperability, advanced analytics, and payer-provider alignment. The workgroup will be reviewing these priorities at its next meeting on June 24th. The workgroup meets on the fourth Monday of each month from 3:00-4:00 ET for those interested in joining.
- The Provider Information Subworkgroup is preparing a survey to explore provider directory challenges such as terminology, data accuracy, and Regulatory requirements for data collection. Please contact [email protected] if you would like to get involved.
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WEDI has an incredible group of member organizations that recognize the value our organization brings to them professionally, as a company and as an industry advocate. Please join us in welcoming some of our newest members!
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Initial industry comments are trickling in on the government health IT arm's proposed
"on-ramp" to national connectivity, highlighting worries the initiative is biting off more than it can chew. Official comments on the second draft of the Trusted Exchange Framework and Common Agreement won't be released until early next week.
Providers, payers and health IT vendors
generally support the idea
, much like they support HHS'
sweeping rules
to promote free data sharing and halt the practice of information blocking. But groups worry the government is doing too much too quickly, with multiple organizations weighing in on the relatively abbreviated timeline of TEFCA implementation and its accompanying administrative burden.
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Michael Peresie, SVP and GM, Medical Network of Change Healthcare details the variety of topics at WEDI National 2018 including Data Exchange, AI, Blockchain, Data Policy
and more.
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Health Plans/Systems
Technology Solutions/Vendors
HR Announcements
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If you are a WEDI Corporate Member organization and would like to have your press releases included in a future edition of the WEDI Monthly Newsletter, please email with a link to your press release to
[email protected]
.
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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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