Minnesota e-Health Advisory Committee Meeting - Co-Chairs: Alan Abramson | Sonja Short February 15, 2019 - Minnesota ...

 
Minnesota e-Health Advisory Committee Meeting - Co-Chairs: Alan Abramson | Sonja Short February 15, 2019 - Minnesota ...
Minnesota e-Health Advisory Committee Meeting

             Co-Chairs: Alan Abramson | Sonja Short
                       February 15, 2019
Minnesota e-Health Advisory Committee Meeting - Co-Chairs: Alan Abramson | Sonja Short February 15, 2019 - Minnesota ...
Topics on Today’s Agenda

 Legislative Update
 HIE Task Force
 E-Prescribing Workgroup
 Minnesota e-Health Summit
 MN e-Health Interoperability Steering Committee
 Consumer Engagement
 21st Century Cures Act and Other e-Health Initiative
  Updates
 Wrap-up and Next Steps
                                                         2
Minnesota e-Health Advisory Committee Meeting - Co-Chairs: Alan Abramson | Sonja Short February 15, 2019 - Minnesota ...
Minnesota e-Health Initiative Charge – Vision

A public-private collaboration established in 2004
   Legislatively chartered
   Coordinates and recommends statewide policy
    on e-Health
   Develops and acts on statewide e-health
    priorities
   Reflects the health community’s strong
    commitment to act in a coordinated, systematic
    and focused way

       Vision: “All communities and individuals benefit from and are
       empowered by information and technology which advances
       health equity and supports health and wellbeing.”
                                                                       3
Minnesota e-Health Advisory Committee Meeting - Co-Chairs: Alan Abramson | Sonja Short February 15, 2019 - Minnesota ...
Legislative Update from MDH

      Diane Rydrych & Jennifer Fritz
           February 15, 2019
Minnesota e-Health Advisory Committee Meeting - Co-Chairs: Alan Abramson | Sonja Short February 15, 2019 - Minnesota ...
Minnesota e-Health HIE Task Force Update
        Task Force Co Chairs: Peter Schuna & George Klauser
Minnesota e-Health Advisory Committee Meeting - Co-Chairs: Alan Abramson | Sonja Short February 15, 2019 - Minnesota ...
Outline for Today

• Updates
  • Progress on deliverables
  • Timeline for remaining meetings
  • Summary of agreements and accomplishments

• Discuss and provide input on critical success factors
• Request for Advisory Committee endorsement

                                                          6
Minnesota e-Health Advisory Committee Meeting - Co-Chairs: Alan Abramson | Sonja Short February 15, 2019 - Minnesota ...
Progress on HIE Task Force Deliverables

Deliverable 1: Action steps for 2018-2019 to implement connected networks by
building upon existing HIO and national network connections
   • Recommendation 1 endorsed by e-Health Advisory Committee on 9/28

Deliverable 2: An implementation plan for 2018-2019 with measureable targets
   • Implementation Plan subgroup for recommendation 1 established and has met four
     times, draft plan for review by Task Force soon

Deliverable 3: A plan for five-year interim governance, authority, and financing
with the goal of optimal HIE
   • Governance discussion started in September, essential elements identified in
     November, continues today with focus on critical success factors and expectations

Deliverable 4: Recommended policy updates to Minnesota’s HIE Oversight Law
   • HIE Review Panel had initial discussion; further action as needed in concert with
     Deliverable 3
                                                                                         7
Minnesota e-Health Advisory Committee Meeting - Co-Chairs: Alan Abramson | Sonja Short February 15, 2019 - Minnesota ...
Timeline for completing HIE Task Force deliverables

February 28   Make preliminary recommendations to address critical success
              factors of alignment and financial commitment as well as authority
              and financing (focus on essential elements for defining services and
              determining governance). Deliverable 3
March 21      Review preliminary recommendations for Advisory Committee
              consideration at April meeting (continue Deliverable 3)
April 18      Review Advisory Committee modifications and make final
              recommendations for Deliverable 3. Make suggestions for initial
              changes to HIE oversight law & related laws (Deliverable 4) for
              Advisory Committee consideration at May meeting
May 30        Review Advisory Committee modifications to recommendations and
              develop plan for public comment in June.
August        Restart HIE Workgroup - meet to review and revise recommendations
September     Final Recommendations for Advisory Committee consideration; move
              forward on implementation
                                                                                 8
Minnesota e-Health Advisory Committee Meeting - Co-Chairs: Alan Abramson | Sonja Short February 15, 2019 - Minnesota ...
Minnesota Connected Networks Approach and
                 Governance Framework (all the gold)

   Nodes of the                               Other Stakeholders of
Connected Networks                           the Connected Networks
                     Preferred Centralized
                        Services of the          Federal initiatives
                     Connected Networks            (e.g., TEFCA)

                           healthcare                  Payers
                            directory
                                                        DHS
                            patient
                           directory
                                                       MDH
                           routing
                          mechanism              Quality Reporting

                                                    Other state
                                                 agencies/programs

                                                   Other state or
                                                 national initiatives
                                                                        9
Minnesota e-Health Advisory Committee Meeting - Co-Chairs: Alan Abramson | Sonja Short February 15, 2019 - Minnesota ...
Summary of Accomplishments and Future Focus Areas

Refer to handout- Summary of HIE Task Force Accomplishments …
 Purpose:
 To acknowledge and highlight the work of the HIE Task Force, including
 activities, discussion and consensus toward a Minnesota connected
 networks approach.
 HIE Task Force promoting incremental approach (focus) to ensure the most
 value and/or return on investment.

 Questions or comments?

                                                                      10
Identified Critical Success Factors (Key Issues)
Deliverable 3- Plan for five-year interim governance, authority, and financing

1) Full participation is needed to achieve the most value for all
     • Dependent on commitment by large health systems- key data contributors

2) One or more HIO(s) is needed to fill HIE connectivity gaps (e.g., smaller,
   independent providers, LTPAC, BH, social services)
     • Dependent on ensuring sustainability for one or more HIO as “safety-net”
3) Financial commitment by all participants (nodes and other
   stakeholders) is needed to ensure long-term sustainability
     • Dependent on participant fee structure (e.g., fees for centralized services)
4) Alignment with other HIE activities (national, federal and state) is
   needed to achieve an efficient and effective network (e.g., minimize
   connections, reduce/eliminate duplicate services)
     • Dependent on flexible governance process that can evolve to meet HIE needs
                                                                                      11
Discussion
                                    Critical Success Factors

• To what extent do you agree that these are critical success
  factors for Minnesota Connected Networks overall? Why?

• Are there others?

• Do you have suggested strategies for any of the critical
  success factors?

                                                                12
Critical Success Factor - Full Participation
                                         Common strategies

Full participation is needed to achieve the most value for all
   • Dependent on commitment by large health systems- key data
     contributors

Summary of common strategies discussion at January 31 meeting
  • support for payer incentives, payer requirements, state government
    incentives or requirements, and stand up one or more centralized
    services incrementally (patient directory, healthcare directory and/or
    routing services)
  • strongest support was behind “stand up one or more centralized services,
    incrementally” to help demonstrate multi-stakeholder value and/or
    return on investment
  • strongest support for patient directory to improve patient matching
                                                                          13
Incremental Approach Strategy

• Using a centralized patient directory or other patient
  matching service, the HIE Task Force will:
  •   Discuss governance needs (e.g., essential elements)
  •   Make recommendations for governance, financing
      and authority
  •   Apply these recommendations to other centralized
      services or connected networks services as needed.

                                                            14
Discussion
                          Incremental Approach Strategy

What are your initial thoughts on this strategy?
To what extent do you agree with this strategy?
Are there other priority strategies that should be
considered?

                                                     15
Request for Advisory Committee Action

Endorse:
• Move forward, using an incremental approach, to
  discuss governance needs using a centralized
  patient directory or other patient matching service.
• General direction for next three months, plan for
  public comment period and final recommendations
  in September

                                                     16
e-Prescribing Workgroup Update

          Karen Soderberg, MDH
        Laura Topor, Granada Health
Overview

• Purpose: Advance comprehensive implementation of e-prescribing standard
  transactions and procedures by Minnesota’s stakeholders.

• The work will address two key issues:
   • Increasing adoption of electronic prescribing of controlled substance by Minnesota’s
     prescribers.
   • Documenting and developing stakeholder consensus on addressing barriers to full
     implementation of the NCPDP SCRIPT standard and e-prescribing processes.
     Stakeholders include prescribers, dispensers, payers, and pharmacy benefit managers.

• Co-chairs:
   • Steve Simenson, Goodrich Pharmacy
   • Lee Mork, Allina Health

• Meetings held 11/14/18, 1/8/19 and 2/13/19

                                                                                            18
Matrix of issues

• Prescriber-Pharmacist communication
   • There is not an efficient and fast way for prescriber and pharmacist to
     communicate (except by phone).

• Cancel messages
   • There is slow uptake of the RxCancel function on both prescriber and pharmacy
     sides.
   • Workflow and technical challenges need to be addressed.

• Indication and/or diagnosis information on script and label
   • Allows pharmacists to better counsel patients and identify issues.
   • Patients are more likely to adhere if they know why they are taking meds.
   • Pharmacy systems are enabled to receive; need to have prescriber send it.
   • Could help in obtaining prior auth from payer if diagnosis code is included on
     claim.
                                                                                      19
Issues, continue

• Formulary and benefit information
   • Often out of date or inaccurate.
   • Information on alternatives, if sent, is sorted alphabetically rather than using a logic model to
     identify preferred alternatives at point of care.
   • Real-time benefit checks will help; proprietary solutions are in use but no industry standards.
• e-Prior Authorization
   • Some are still doing this retrospectively (i.e., pharmacy-directed) due to inaccurate formulary
     and benefit data.
   • MN requirements (from AUC) don’t align.
• MME (morphine milligram equivalent) decision support
   • Several MME calculators exist but formulas appear to be inconsistent and don’t include
     liquid and patches. Pediatric calculator in Epic is not safe.
• Medication lists and reconciliation
   • Real-time information is needed for a single source of truth for medications.
   • Need to think not just about opioids, but also future information needs. Be prepared to
     manage the next crisis.
                                                                                                    20
Next steps

• Road show outreach

• Continue to flesh out issues and opportunities
   • Potentially identify an “eUC” use case to develop

• Next meeting on March 14 (2-4pm; location TBD) – Join us!

• Questions? Contact Karen.Soderberg@state.mn.us

                                                                       21
Minnesota e-Health Summit Planning

          Sue Severson| Jennifer Fritz
              February 15, 2019
Minnesota e-Health Summit

15th Anniversary Summit: Information that Works
         Thursday, June 13, 2019

               Keynote Speaker
               Dr. Vindell Washington
               Executive Vice President and Chief Medical Officer
               Blue Cross and Blue Shield of Louisiana

                                                              23
15th Anniversary Minnesota e-Health Summit

New Venue: Minnesota Landscape Arboretum

                                            24
15th Anniversary e-Health Summit

Current Opportunities
 New Sponsorship Levels (see handout)
 Refer Potential Sponsors/Exhibitors
 Sign-up today
 Share ideas on program format:
  Plenary session topics/panels/learning labs

                                                25
Minnesota e-Health Interoperability Steering Committee

                        Jennifer Fritz
                      February 15, 2019
E-Health MDH Interoperability Advisory Group

                                              Membership
• Cathy Gagne, PHN, St. Paul-Ramsey Department of        • Emily Emerson, Assistant Division Director, Infectious
  Public Health                                            Disease Epidemiology, Prevention, and Control,
                                                           Minnesota Department of Health
• Nancy Garrett, Chief Analytics Officer and Senior Vice
  President for Information Technology, Hennepin         • Myra Kunas, Assistant Division Director, Public Health
  HealthCare                                               Laboratory, Minnesota Department of Health

• Jonathan Shoemaker, SVP and Chief Information and • Chuck Stroebel, Assistant Division Director, Health
  Improvement Officer, Allina Health                  Promotion and Chronic Disease, Minnesota
                                                      Department of Health
• Meyrick Vaz, Vice President, Strategic Market
  Partnerships, UnitedHealthcare Office of the CIO  • Jennifer Fritz, Director, Office of Health IT, Minnesota
                                                      Department of Health
• Shawn Kammerud, Chief Information Security
  Officer\Director Service Management, Minnesota IT • Karen Welle, Director, Office of Data Strategy and
  Services, Partnering with Minnesota Department of   Interoperability, Minnesota Department of Health
  Health
                                                    • Tony Steyermark, Supervisor of MDH Interoperability,
• Heather Petermann, Division Director, Health Care   Office of Health IT, Minnesota Department of Health
  Research & Quality, Minnesota Department of Human
  Services

                                                                                                             27
E-Health MDH Interoperability Advisory Group
   February 6 Meeting Update – Summary of Discussion

• Reviewed charter
• Provided an overview of MDH interoperability scope of work, roles and
  responsibilities within MDH
• Discussed current barriers and opportunities related to interoperability
  with MDH
   • Today’s work is built on the groundwork laid by the e-Health Advisory
     Committee starting in 2009 on Interoperability, Standards, and Meaningful
     Use.
   • Develop list of MDH Interoperability projects (in process)
   • Develop a State Agency Community of Interest for Interoperability
   • Need for plain language and common understanding of the data security
     architecture is important for building trust and relationships
• Next Meeting: April 2019
                                                                             28
Promoting Interoperability Progress to date (Examples)

• Electronic Laboratory Reporting (ELR)
    • Working with hospitals to onboard, developing HL7 2.5.1 message importing capability,
      application system improvements

• Infectious Disease Laboratory
    • New application development with full HL7 messaging capacity, developing plan to identify
      pilot sites and piloting process
• Immunizations
    • Working with clinics and hospitals to onboard, application system improvements, updating
      documentation for meaningful use reporting to identify opportunities for standardization
      and efficiencies, working to pilot onboarding through a Health Information Organization
• Newborn Screening Program
   • Developing requirements for electronic lab ordering
• Blood Lead Program
   • Developing requirements for improved electronic data exchange

                                                                                         29
MDH Coordination Progress to date

• Interviewing for Director of Office of Data Strategy and Interoperability
• Drafting and implementation of MDH interoperability roadmap
   • Enhancements to MDH internal exchange infrastructure (MDH Data Exchange /
     Orion Rhapsody) to meet program and stakeholder needs
   • Funding to incentivize connectivity through a Health Information Organization
     for Promoting Interoperability program (Meaningful Use)
   • Continued work on MDH Interoperability Data Inventory
   • Development of MDH Interoperability Communication Plan
• Planning for submitting application for 90/10 funding for Federal Fiscal Years 2020
  and 2021

                                                                                   30
Remember,
              Don't forget!

Consumers

            How to engage
            with e-Health
               Initiative
              Activities?
Terms Ending – June 30, 2019

• Dentists (1 yr)                                  • Pharmacists (1 yr)

• Long Term Care (2 yr)                            • Large Hospitals (2 yr)

• Expert in HIT (2 yr)                             • Vendors (2 yr)

• Consumer (2 yr)                                  • Health Care Purchasers & Employers
                                                     (2 yr)
• Research (2 yr)

Next Steps:
• Incumbents will receive an email with instructions for re-applying
• A public call for applicants will be issued by the Minnesota Secretary of State
• Expand / assist recruitment to seek more diverse participation &
  membership
                           Optional Tagline Goes Here | mn.gov/websiteurl             32
Co-Chair Nomination and Selection Process

Appointing Authority
   • Commissioner appoints Co-Chairs from amongst Advisory Committee members

Nominating Co-Chairs
   • Nominations taken from Committee members including co-chairs and alternates

Term Cycle
   • Two-year staggered term cycle to ensure continuity in leadership

Process:
   • Members will receive email with request to nominate candidates for Co-Chair
     vacancy. Respond in 10 days by email to Bob Johnson at
     bob.b.Johnson@state.mn.us

                                                                                   33
21st Century Cures Act Proposed Rule

        Kari Guida | Senior Health Information
Provider Burden Coordinated Response

         Kari Guida | Senior Health Information
Strategy on Reducing Regulatory and Administrative Burden
              Relating to the Use of Health IT and EHRs Report

• Released in November 2018, Submitted January 2019

• Three primary goals for reducing health care provider burden:
   • Reduce the effort and time required to record information in EHRs for health care
     providers during care delivery.
   • Reduce the effort and time required to meet regulatory reporting requirements for
     clinicians, hospitals, and health care organizations.
   • Improve the functionality and intuitiveness (ease of use) of EHRs.

• https://www.healthit.gov/sites/default/files/page/2018-
  11/Draft%20Strategy%20on%20Reducing%20Regulatory%20and%20Administ
  rative%20Burden%20Relating.pdf

                                                                                         36
Coordinated Response
                                                      Prioritized Recommendations

• Continue to reduce overall regulatory burden around documentation of patient encounters.
  (Clinical Documentation, Strategy 1, Recommendation 1)

• Leverage data already present in the EHR to reduce re-documentation in the clinical note.           (Clinical
  Documentation, Strategy 1, Recommendation 2 )

• Evaluate and address the other process and clinical factors contributing to burden associated
  with prior authorization. (Clinical Documentation, Strategy 3, Recommendation 1)

• Continue to promote nationwide strategies that further the exchange of electronic health
  information to improve interoperability, usability, and reduce burden. (Health IT Usability and the User
  Experience, Strategy 4, Recommendation 4)

• Federal agencies, in partnership with states, should improve interoperability between health IT
  and PDMPs through the adoption of common industry standards consistent with ONC and CMS
  policies and the HIPAA Privacy and Security Rules. (Public Health Reporting, Strategy 1, Recommendation 1)

• HHS should increase adoption of electronic prescribing of controlled substances with access to
  medication history to better inform appropriate prescribing of controlled substances. (Public Health
  Reporting, Strategy 1, Recommendation 2)

                                                                                                               37
e-MNDOSA Project

   Kari Guida & Company
Minnesota Drug Overdose and Substance Use Pilot
                         Surveillance System (MNDOSA)

MNDOSA is a surveillance system to track emergency department visits and
hospitalizations attributable to the recreational use of drugs and other
substances, excluding alcohol alone.

Surveillance of suspected overdose or substance use will allow us to:
• determine the burden of substance use/overdoses seen in select emergency
  departments and hospitals in Minnesota

• identify clusters of ED visits/hospital treatment for drug overdoses

• identify substances causing clusters, unusual or atypical clinical presentation, and severe
  illnesses in order to inform approaches to treatment and prevention

• describe the populations most affected to help focus and guide prevention efforts

                                                                                            39
Current MNDOSA High Level Process Diagram

                                        40
e-MNDOSA Project
                                                                             Overview

e-MNDOSA Project: assessing options for electronic standards-based
exchange of information from emergency departments to MDH for drug
overdose events
•   CDC “Surge” funding was awarded in the fall of 2018 to combat the opioid crisis
    (Sept 2018 – Aug 2019)
•   Injury and Violence Prevention Section (IVPS) and the Office of Health Information
    Technology (OHIT) are collaborating on e-MNDOSA Project and its objectives:
    •   Train IVPS staff in informatics, e-health, the Minnesota and public health reporting e-health
        ecosystems, standards-based exchange, etc.
    •   Engage local, state and federal partners to provide guidance and recommendations to
        implement and pilot e-MNDOSA.
    •   Identify robust requirements for standards-based exchange for drug overdose surveillance
        through e-MNDOSA.
    •   Develop recommendations and next steps for standards-based exchange for e-MNDOSA.

                                                                                                        41
Methods and Approach

• Using a collaborative team model
   • IVPS and OHIT

• Leveraging stakeholder engagement
   • Advisory Group, Interested Individuals, MN e-Health Initiative, and more

• Applying a multi-prong approach
   • Assess Information, Workflow, and Requirements
   • Develop and Validate Models (current and future)
   • Discover Opportunities for Improvement

                                                                                42
Initial Advisory Group Discussion

Identifying patients that meet the case definition is difficult. The following are
considerations when thinking about identifying patients:
• There is not one ICD-10 code that meets the MNDOSA case definition. There are 1)
  numerous codes for drug overdoses; 2) various ways the codes are implemented both within
  a facility and across facilities; and 3) gaps in the codes (not all types of drugs individuals
  overdose on are in the code set).

• When figuring out this issue, need to consider implications of over reporting and
  underreporting.

• Providers are looking at symptoms and do not know about drug use until the labs come back
  which can be the first time drug use is noted in the medical record.

• Altered mental state is used to assure the encounter gets billed. This includes for alcohol and
  other drug overdoses.

                                                                                                43
Connected to Minnesota e-Health Initiative

• Crossover between participants

• Provide updates and seek input at Advisory Committee meetings

• Interested in more detail, contact kari.guida@state.mn.us

                                                                  44
Operationalizing Value Based Health Care in a
            Fee for Service world
     Brief Update: CAQH/CORE Value Based Purchasing Advisory Group
                 Minnesota e-Health Advisory Committee
                           February 15, 2019

        PROTECTING, MAINTAINING AND IMPROVING THE HEALTH OF ALL MINNESOTANS
Purpose – create awareness, seek input

•     MDH is part of a national CAQH/CORE Advisory Group advising on “operating
      rule” development/updates to address the needs of the payment continuum
      from FFS to VBP.

•     MDH is seeking input and feedback to provide as part of its advisory role.

2/14/2019              P RO TECTIN G, MAIN TAIN IN G AN D IMP RO VIN G THE HEAL TH O F AL L MIN N ESO TAN S   46
Overview

• CORE background

• CORE study and findings

• Next steps

2/14/2019           P RO TECTIN G, MAIN TAIN IN G AN D IMP RO VIN G THE HEAL TH O F AL L MIN N ESO TAN S          47
CAQH/CORE

•     More than 130 organizations – providers, health plans, vendors, government
      agencies, and standard-setting bodies – developing operating rules to simplify
      healthcare administrative transactions

•     Designated the Secretary of the Department of Health and Human Services
      (HHS) as the author for federally mandated operating rules per Section 1104 of
      the ACA.

•     Operating rules: (per ACA) “the necessary business rules and guidelines for the
      electronic exchange of information that are not defined by a standard or its
      implementation specifications.”

2/14/2019              P RO TECTIN G, MAIN TAIN IN G AN D IMP RO VIN G THE HEAL TH O F AL L MIN N ESO TAN S           48
CORE 18 Month Study and Report

•       “The success of value-based payment is … dependent upon smooth and
        reliable business interactions between all stakeholders … especially between
        healthcare providers and health plans.”

•       CAQH CORE conducted an 18-month study to examine value-based payment
        operational processes
           •       Identify opportunity areas that, if improved, would streamline implementation of
                   value-based payment.

    All Together Now: Applying the Lessons of Fee-for-Service to Streamline Adoption of Value-Based Payments. CAQH-CORE.
    https://www.caqh.org/sites/default/files/core/value-based%20payments/core-value-based-payments-report.pdf

2/14/2019                              P RO TECTIN G, MAIN TAIN IN G AN D IMP RO VIN G THE HEAL TH O F AL L MIN N ESO TAN S   49
How well does the existing model work?

2/14/2019   P RO TECTIN G, MAIN TAIN IN G AN D IMP RO VIN G THE HEAL TH O F AL L MIN N ESO TAN S   50
Findings and challenges

•     VBP models require certain information to be deployed earlier in the workflow
      and/or exchanged more often.

•     New data unique to VBP models are also needed at various stages of the
      revenue cycle

•     As the types of VBP models continue to grow and vary, providers and health
      plans will need consistent and uniform methods to exchange this information
      in a timely, cost- effective manner.

2/14/2019             P RO TECTIN G, MAIN TAIN IN G AN D IMP RO VIN G THE HEAL TH O F AL L MIN N ESO TAN S   51
Non-uniformity is currently the norm in value-based
                                        payment implementation

 More standardization is needed
•… especially for “data quality and
 standardization, interoperability, patient risk
 stratification, provider attribution and quality
 measurement.”

  Don’t let history repeat itself!
  All Together Now: Applying the Lessons of Fee-for-Service to Streamline Adoption of Value-Based Payments. CAQH-CORE.
  https://www.caqh.org/sites/default/files/core/value-based%20payments/core-value-based-payments-report.pdf

2/14/2019                           P RO TECTIN G, MAIN TAIN IN G AN D IMP RO VIN G THE HEAL TH O F AL L MIN N ESO TAN S   52
CORE Advisory group

• Review “challenges and opportunities”

•     Translate to possible priorities for operating rules, other standardization
      efforts

•     Meeting over next several months

2/14/2019              P RO TECTIN G, MAIN TAIN IN G AN D IMP RO VIN G THE HEAL TH O F AL L MIN N ESO TAN S   53
2/14/2019   P RO TECTIN G, MAIN TAIN IN G AN D IMP RO VIN G THE HEAL TH O F AL L MIN N ESO TAN S   54
More information

• Contact:

  David Haugen

  MDH Administrative Simplification Program

  David.Haugen@state.mn.us

  Thank you.

  (See additional following “outtake” slides for additional information)

2/14/2019             P RO TECTIN G, MAIN TAIN IN G AN D IMP RO VIN G THE HEAL TH O F AL L MIN N ESO TAN S      55
“Outtake #1”-- Value Based Health Care

•      “… a healthcare delivery model in which providers, including hospitals and
       physicians, are paid based on patient health outcomes.”

•      “Value-based care differs from a fee-for-service or capitated approach, in
       which providers are paid based on the amount of healthcare services they
       deliver. The “value” in value-based healthcare is derived from measuring
       health outcomes against the cost of delivering the outcomes.”
    What Is Value-Based Healthcare? NEJM Catalyst, January 1, 2017 https://catalyst.nejm.org/what-is-value-
    based-healthcare/

2/14/2019                   P RO TECTIN G, MAIN TAIN IN G AN D IMP RO VIN G THE HEAL TH O F AL L MIN N ESO TAN S   56
“Outtake #2” -- VBP brings new demands, challenges

•     Much more data needed
     • Quality
     • Attribution of patients to providers
     • “Apples to apples comparisons” -- Risk assessment, risk adjustment

• Differing, siloed systems
     • Claims vs. EHRs
     • Separate data warehouses and reporting

• Differing terminology, language

2/14/2019                 P RO TECTIN G, MAIN TAIN IN G AN D IMP RO VIN G THE HEAL TH O F AL L MIN N ESO TAN S   57
“Outtake #3” -- Don’t let history repeat itself

• Many features of value-based payment do not align with the current
  fee-for-service operational system.
• …. proprietary systems and processes for implementing value-based
  payment have already begun to introduce operational variations.
• Without collaboration to minimize variations, the current environment
  is ripe for repeating a scenario that cost stakeholders billions of dollars
  and slowed and complicated adoption of fee-for-service transactions.
• … by applying lessons learned…, CAQH CORE hopes to energize an
  effort to ease value-based payment operational inefficiencies.

2/14/2019          P RO TECTIN G, MAIN TAIN IN G AN D IMP RO VIN G THE HEAL TH O F AL L MIN N ESO TAN S   58
“Outtake #4”

2/14/2019   P RO TECTIN G, MAIN TAIN IN G AN D IMP RO VIN G THE HEAL TH O F AL L MIN N ESO TAN S              59
Meeting Wrap-up

Next Steps
 Upcoming Workgroup/Task Force Meetings
    Consumer Engagement - Patient Journey Mapping: Monday, February 25 12:00 -2:00
     p.m. Normandale Community College
    HIE Task Force: Thursday, February 28 9:00 a.m. – 12:00 p.m. | Wellstone Center

 Next Advisory Committee Meeting
    Monday, April 22, 2019, 1:00 p.m. – 4:00 p.m. | Medtronic, Fridley

 2019 Minnesota e-Health Summit: Information that Works.
    Save the Date: June 13, 2019 | Minnesota Landscape Arboretum, Chaska

                                                                                       60
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