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Dear WEDI Members,

I have recently returned from the HIMSS 2019 Annual Conference, and I must say that as large and sometimes overwhelming as the event is, there are so many important discussions happening across the industry that it covers. I am thankful for the opportunity for WEDI to be a part of those. I truly believe that our organization brings such unique value to the critical issues and policies impacting health care information exchange and the efficiency of the system through our membership involvement from every faucet of the industry. And I am thankful that others are very interested in the work WEDI is doing.

As we move further into 2019, WEDI is intensely focused on our educational foundation. We have a number of upcoming webinars, our Spring Conference and our Summer Forum all highlighted within this newsletter edition. I look forward to next connecting you all in person in San Diego in May. It will be an impressive gathering of great minds of health care, and an excellent glimpse into the initiatives underway within our many Workgroups and Subworkgroups. I encourage you all to register to join us early!

Should you ever have any questions or be looking for ways in which you can become more involved with WEDI, please don’t hesitate to contact us.

Best regards,
Charles Stellar
WEDI President & CEO
Have you seen the latest speakers added for WEDI’s Spring Conference? Our glimpse at our conference agenda is a multi-stakeholder look at educational and informative sessions that improve healthcare information exchange in order to enhance the quality of care, improve efficiency and to reduce costs of the American healthcare system.
Additionally, we have some exciting sessions from the following WEDI Workgroups which will be open to all members and non-members: Telehealth, Payment Models, Claims, Remittance Advice and Payment, and Claim Status.

We invite health IT professionals across all sectors – payer, provider, government and healthcare technology vendors – to explore the critical challenges the healthcare industry faces in San Diego with us, such as:

  • The Imperatives for Interoperability Standards in the Future of Healthcare and Plecosystem Economy
  • The Changing Dynamic in Healthcare Security: The risk or the promise?
  • Understanding the Models, Transactions, and Data Flows of Encounter Data Reporting
  •  Best Practices for EFT Enrollment Security
  • Provider Adjustments (PLB) in the Electronic Remittance Advice (835) – How do they work?
  • Anatomy of Value-Based Payment: An Interactive Discussion
  • Barriers to the Broader Adoption of Telehealth
  • Using Analytics to Identify Departures from Medical Coding Standards
  • 2018 CAQH Index® Findings: Immediate Opportunities to Save Time and Reduce Business Cost
  • Delivering More Efficient Prior Authorization and Attachment Electronic Transactions through Operating Rules
  • Value or Cost: Electronic Claim Status Request and Response
Formed under the guidance of the WEDI Board of Directors to create a forum for communication between primary stakeholders in the prior authorization process, the 12-member lead Prior Authorization Council (PAC) includes the American Medical Association (AMA), America's Health Insurance Plans (AHIP), Blue Cross Blue Shield Association (BCBSA), Council for Affordable Quality Healthcare (CAQH), the Cooperative Exchange (CE), Healthcare Administrative Technology Association (HATA), Health Information Management Systems Society (HIMSS), HL7, Medical Group Management Association (MGMA), National Council for Prescription Drug Programs (NCPDP), WEDI and X12.

This month, the PAC released its first work product – an industry white paper addressing the high level of administrative burden associated with obtaining prior authorization. The paper outlines the work being done by the council to build a cross-stakeholder view of prior authorization in the US, as well as recommendations for policy development, standardization, and gap identification including both workflow integration and automation.
Understanding MACRA, MIPS and APMs Webinar
Tuesday, March 5, 2019 (3:00-4:00 p.m. ET)

In April 2015, value-based payment transformation accelerated when Congress passed the Medicare Access and CHIP Reauthorization Act (MACRA) establishing two data-driven payment tracks: alternative payment models (APMs) and the merit-based incentive payment system (MIPS). Commercial payers are deploying such payment reform programs, as well. MACRA has been particularly prescriptive in its design of value-based payment (VBP). MACRA and related federal policy has fast-tracked the shift of healthcare payment from volume- to value-based reimbursement under the Quality Payment Program (QPP).

Join us this session exploring the waters of payment transformation through the use of data, and essential strategies, operations and technologies needed to succeed under population-based payment archetypes associated with alternative payment models (APMs) and the merit-based incentive payment system (MIPS) set forth under MACRA.

By the end of the presentation, attendees will be able to:

  1. Identify the four categories of value-based reimbursement transforming provider economics under MACRA and payer industry trends.
  2. Articulate the role of effective data capture to determine the value of services and healthcare reimbursement under population-based payment (PBP) models.
  3.  Formulate strategies that align with MACRA quality and value measurement among organizational leaders.

A certificate of education is available for this webinar. WEDI is hosting this webinar
FREE for premium members , $49 for members and non-members are also welcome
to attend for a cost of $199.
Just for Members Monthly Webinar Series:
GAO Report on Patient Matching
Thursday, March 7, 2019 (2:00-3:00 p.m. ET)

Health care providers increasingly share records electronically. It can be hard to match records to the right patient, and mistakes can have consequences. For example, a doctor might use information from the wrong record when treating a patient.

Inaccurate, incomplete, or inconsistently formatted data can make record-matching difficult. These data problems can happen for many reasons, e.g., a patient can go by a full name in one record and a nickname in another.

The U.S. Government Accountability Office (GAO) explored possible solutions, such as requiring a specific format for recording a patient’s name and address, and sharing best practices for record-matching.

Join us as representatives from GAO provide an overview of their report and what they found during the course of their work.

WEDI is hosting this webinar FREE for all members .
Eligibility & Benefits 101 Webinar
Wednesday, March 13, 2019 (2:00-3:00 p.m. ET)

Join us as we work through the history, regulations, purpose, scope, work flow, and transaction functions. A certificate of education is available for this webinar.

WEDI is hosting this webinar FREE for premium members , $49 for members and non-members are also welcome to attend for a cost of $199.
Webinar – Just What are the Barriers to Broader Adoption of Telehealth: Results from the WEDI Survey
Thursday, March 28, 2019 (2:00-3:00 p.m. ET)

Attend to hear the results of WEDI’s recent survey exploring the barriers to the broader adoption of telehealth. The Telehealth Workgroup conducted the survey in the fall to learn from providers, payers, and patients about the advantages and disadvantages they have experienced or perceive related to the delivery of health care services through telehealth. With 200 responses, the results give insights into what the industry can do to further expand telehealth services. As attendees, you will also get the opportunity to provide your input on your experiences with telehealth.

A certificate of education is available for this webinar. WEDI is hosting this webinar FREE for premium members , $49 for members and non-members are also welcome to attend for a cost of $199.
All of our workgroups have special projects and activities underway, here’s just a brief highlight of a few:

  • Join the Claim Status Subworkgroup as they sift through the recent WEDI Claim Status Survey results, identify trends and determine next steps. Calls are held the first Friday of the month at Noon Eastern Time. Mark on your calendar March at noon to attend the upcoming call.
  • The Remittance Advice & Payment SWG is finalizing the paper on Guidance for Using the PLB Segment in the 835 Transaction, and preparing two sessions for the Spring Conference in May. We also will be meeting face to face on Monday at the Spring Conference – we hope to see you there!
  • The Payment Models Workgroup (PMWG) will be meeting on Monday, February 25th from 3:00-4:00 PM ET to outline goals for 2019; and, will be leaping into action with some rapid response workgroup meetings in March and April. On the 25th, we will be discussing our role as a collaborating entity with several organizations, including the Da Vinci Project and CAQH, who are already tackling use cases and technical details. We are also planning to have an onsite/remote dial-in workgroup meeting during the May conference in La Jolla. You can expect to see our survey very soon. Responses will be used to inform our focus a workgroup, beginning with an Issue Brief around the individual needs and challenges related to payment innovation. We need your help, suggestions and brain-power. Please plan to join us! 
  • Did you take the Telehealth Workgroup’s survey on the barriers to the broader adoption of telehealth? Join us for an interactive webinar on March 28 at 2 pm ET to review the findings of the survey and examine how perspectives of providers, payers, and patients align and differ. The workgroup is using the findings from the survey to help inform their latest paper and to better understand how barriers may differ and align among payers, providers, and patients. The workgroup is also organizing a session for the WEDI spring conference that will focus on the return on investment and payment policies associated with telehealth.
  • The Provider Information subworkgroup is creating two surveys, one to be sent to the providers and one to the payers both seeking information on what current provider data is being requested and supplied and what additional provider data do each feel should be requested. If you’d like to join in the effort, please join us at our next meeting 3/11/19 at 3 PM EST. 
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.
Here is one of our newest members. Please join us in welcoming them!
Interested in finding out which other organizations value WEDI membership just as much as you do? View our full listing of WEDI Members here.
In one of our latest videos taken at the WEDI National Conference, Dr. David B. Muhlestein, Chief Research Officer of Leavitt Partners, LLC shares his perspectives
on WEDI National 2018.
Visit the WEDI Vimeo Channel to view our entire video library!
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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 jennifer@andersoni.com.
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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