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groups:healthcare:2018_09_25_payor_hcwg

Hyperledger Project
Healthcare Working Group (HCWG) Payor Subgroup Meeting
September 25, 2018

Resources:
Chat: ​https://chat.hyperledger.org/​channel/​healthcare-wg ​(you can use your LFID to login)
Github: ​https://github.com/​hyperledger
Wiki: https://wiki.hyperledger.org
HCWG Wiki: https://wiki.hyperledger.org/groups/healthcare/healthcare-wg
Public lists: https://lists.hyperledger.org
Meetings: https://wiki.hyperledger.org/community/calendar-public-meetings

Linux Foundation Antitrust reminder: https://www.linuxfoundation.org/antitrust-policy

Richard Cole - Value Based Care
Data warehouse architect - over 400 providers in every specialty - work with local hospitals
SME value based care

8:00 What is value based care?
An incentive program created by CMS - affordable care act
Better care for populations at lower cost

8:40 Clinical measures as one element of the “Triple Aim”
Reward value over volume - Outcome based measures
Insurers are members

10:00 How orgs implement VBC?
EHR systems
Patient centered certifications
Care optimization teams
Quality scorecards - provider and payor
Provider salary based on quality based care

12:30 CMS/QPP and MSSP/ACOs
Performance is heavily weighted by quality
Incentive to make sure they do well on these measures, payments adjusted

14:00 Insurers role via contracts with Health Care Organizations
HEDIS specs and benchmarks
Feedback mechanism to let them know how well they are doing

17:00 PROBLEM: Insurer member to EHR Patient matching routines
No standard format
Duplicate records

19:45 Blockchain Use Case Opportunities
Social security numbers are a big problem
Universal patient identifier
When patients change insurance companies - 360 view of patient health

21:30 Questions and discussion

groups/healthcare/2018_09_25_payor_hcwg.txt · Last modified: 2018/10/09 18:54 by Jennifer DeVivo