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Enabling Provider-Payer Collaboration: An Essential Conversation
Session 94, February 21, 2017
Floyd Eisenberg, iParsimony, LLC | Mike Hurley, Hyland |
Lenel James, BlueCross BlueShield Association
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Speaker Introduction
Lenel James, MBA, CPHIT
Business Lead – Health Information Technology & Innovation
BlueCross BlueShield Association
Planning Committee Member, HL7 Payer User Group
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Conflict of Interest
Lenel James
Has no real or apparent conflicts of interest to report.
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Speaker Introduction
Floyd Eisenberg, MD, MPH, FACP
President
iParsimony, LLC
Co-Chair, HL7 Clinical Quality Improvement
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Conflict of Interest
Floyd Eisenberg
Has no real or apparent conflicts of interest to report.
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Speaker Introduction
Mike Hurley
Manager, Healthcare Payers
OnBase by Hyland
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Conflict of Interest
Mike Hurley
Has no real or apparent conflicts of interest to report.
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Agenda• Welcome and Introduction
• Overview of the Format for the Roundtable Discussion
• Setting the Stage:
– Pathway to Better Care – past and future
– Quality Measurement Moving Forward
– Interoperability’s Last Mile: Workflow
– Hot Topics
• Your Turn: Issue Selection & Breakout Scrums
• Wrap-up and Next Steps
– Today and Tomorrow
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Learning Objectives
• Describe “Hot Topics” regarding essential data sources, stakeholders and technology capabilities necessary for provider-payer collaborations
• Share experiences, successes and challenges with data and information exchange in provider-payer collaborations
• Discuss and assess gaps, barriers, and challenges in key areas selected by the audience
• Initiate the compilation of ideas for next-steps, strategies, and steps for a path forward
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Setting the Stage
• Pathway to Better Care – Past and Future
• Quality Measurement Moving Forward
• Interoperability’s Last Mile: Workflow
• Hot Topics
11https://www.bcbs.com/primary-source/article/four-pathways-better-care
A Pathway to Better Care in America
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Standards for Quality: Measurement & Clinical Decision Support - History
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Standards for Quality: Measurement & Clinical Decision Support – Moving Forward
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Interoperability’s Last Mile: Workflow
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Hot Topics1. Tangibles for Value-Based Transformation in a Fragmented Care Continuum |
Rahul Dubey
2. Living in a Hybrid Standards World, the HL7 Partners-In-Interoperability Perspective | Russ Leftwich, MD
3. Medication Management, The Evolution of the Pharmacist eCare Plan | Shelly Spiro
4. MIPS – The Road Ahead for Specialty Providers in Value-Based Care | Mike Brody, DMP
5. Health Literacy & the Challenge of Managing Consumer Preferences | Lisa Nelson
6. Sharing Interoperability Pain: Can Payers Use HL7 FHIR to Finally Share Clinical Data? | Paul Oates
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Your Turn
• Topic Selection by You
• Breakout Scrums
Scrum Discussion:
• What was applicable from HIMSS17?
• What is novel or innovative news from your organization or industry perspective?
• What are “next steps” options and strategies the group, HIMSS or HL7 should consider?
http://webcollaboration.biz/himss17
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Your Topic Selection(s)
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Your Turn: What Do You Think?
Breakout #1 report out
Breakout #2 report out
Breakout #3 report out
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Next Steps
• Join in at the March 21/22 HL7 Partners-In-Interoperability @ Georgia Tech
• Join HL7, BCBSA & AHIP April 11/2 Value-Based Care FHIR Mini-Connectathon @ Chicago Microsoft Midwest Technology Center
• Participate in “Hot Topics” Webinars via email invites from HIMSS
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HIMSS Payer Forum Tour at the Interoperability Showcase | Booth 9000, Hall F, Meet-up Desk | 1:00pm – 2:00pm
After learning from thought leaders and engaging with peer during the HIMSS Payer Forum on issues around value-based specialty care payer models, population health technology and collaborations, and data and information enablers, come tour the Interoperability Showcase to further explore how standards-based health IT can enable provider-payer collaborations in this new value-based ecosystem.
HIMSS Payer Forum Meetup at the HIMSS Spot | Lobby C | 3:00pm – 3:45pm
Partners: BCBSA, HL7 | AHIP Innovation Lab
Meet Lenel James, Business Lead, Health Information Exchange & Innovation, BlueCross BlueShield Association and Rahul Dubey, Senior VP, Innovation and Solutions, America's Health Insurance Plans at the Payer Forum meetup and continue the dialogue on options and strategies for a path forward toward improved provider-payer collaborations in this new value-based ecosystem.
Continue the Learning. Continue the Discussion
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ContactsShelley Price, MS, FHMSS
Director, Payer and Life Sciences
HIMSS North America
[email protected] | 703-967-4425 | @SPriceHIMSS | #PutData2Work
Lenel James, MBA, CPHIT
Business Lead – Health Information Exchange & Innovation
Industry Standards & eHealth, National Programs Division
BlueCross BlueShield Association
[email protected] | 312-297-5962
