2024-01-17 (CANCELLED) Patient Cost Transparency Meeting - Da Vinci (2024)

Chairs: Corey Spears Vanessa Candelora

Scribe: Vanessa Candelora

Agenda Topics

Agenda Outline

Agenda Item

Meeting Minutes from Discussion

Management

Review ANSI Anti-Trust Policy

2024-01-17 (CANCELLED) Patient Cost Transparency Meeting - Da Vinci (1)

Housekeeping

Welcome back and Welcome any newcomers!

Announcements


Reminder: Cancelled for Connectathon on 1/17.

See you on 1/24.

Project Update

PCT STU1.1Published! https://hl7.org/fhir/us/davinci-pct/STU1.1/

Remaining Tickets will be included in Ballot, targeting May 2024 cycle.

January Connectathon (Virtual) Kick Off was Dec 13th.

January 16-18, 2024 Registration now open: January 2024 Virtual Connectathon - Da Vinci Tracks

PCT Usual Track Focus, plus testing the AEOB Summary, and other new areas from phase 2 efforts! Please reach out to Rick Geimer , Corey Spears andVanessa Candelora if you are interested in a specific testing area. We can help find partners for you.

Track Proposal: 2024 - 01 Da Vinci Patient Cost Transparency (PCT)

Track Orientation / Kick off - See PCT Track pagefor slides and recording.

Fill out your surveyif you have not already!

Online registration is available until the end of the day on Tuesday, January 16th, 2024

GFE Tiger Team - Providers Update (1min)

We are convening.

Da Vinci Patient Cost Transparency (PCT) team is gathering providers and facilities to convene and discuss Good Faith Estimates and the process to coordinate with other providers and facilities for this No Surprises Act requirement.

Format: 1-hour meetings every other week/2x per month for 8-10 weeks

Goal: Convene diverse provider organizations to solicit, synthesize and define the data exchange needs of Convening Providers/Convening Facilities and Co-Providers/Co-Facilities to create Good Faith Estimates under the No Surprises Act.

Our goal is not to repeat other conversations throughout the industry, but to leverage other conversations and bring people together around discovery of data requirements and workflow process. If you are aware of this conversation occurring somewhere else, please let us know.

Please email DaVinci PMOdavincipmo@pocp.com with subject “Interest in Provider GFE Tiger Team.”

Phase 2: Requirements for Provider to Provider GFE

Continued Discussion on the Provider to Provider GFE Notification, Acknowledgement, and GFE sharing workflow.

Goals for the call today (1/10/2024):

1) Update on Profiles for Phase 2 (see separate branch: https://build.fhir.org/ig/HL7/davinci-pct/branches/phase_2/

  • FYI - This is a current development branch.
  • Note this link contains IG work based on consensus-building in this open forum, but because we are pre-voting in the HL7 process, this IG Version is not available through the "Publication (Version) History"

2) FHIR(r) Task Resource Elements & workflow, such as:

  • Priority,
  • Dates - Restrictions and Extensions Technical Discussion;
  • Provider cannot be reached process


Reminder: Cancelled for Connectathon on 1/17.

See you on 1/24.


Chat


Adjourned at pm ET

Supporting Documents

Outline Reference

Supporting Document

Previous Minutes
Supporting Information Links

Patient Cost Transparency Supporting Materials

  • Da Vinci PCT Glossary
  • Da Vinci Steering Committee PCT Scope Statement
  • Patient Cost Transparency FAQs
  • PCT Discovery and Requirements - Example Scenarios
  • PCT Phase 2
  • PCT Project Tracking
  • PCT Phase 1 Requirements Gathering
  • PCT Future Enhancements
  • Connectathon Planning
  • Patient Cost Transparency, Release 1.1 - US Realm
Phase 2 Info

Phase 2: The goal is to define standard exchange for Provider to Provider GFEminimumviable requirements with space for optional, useful data to drive better estimates for patients without additional burden.

Slides from summary of discussions:Da Vinci PCT Phase 2 Requirements - Sept 2023.pptx

Detailed Data Elements: PCT Phase 2 Elements 2023 07 14.xlsx

Useful Links

Continuous Integration Build IG: https://build.fhir.org/ig/HL7/davinci-pct/

Github: https://github.com/HL7-DaVinci/test-pct-payer

Zulip for FHIR Community to share feedback:https://chat.fhir.org/#narrow/stream/301151-Da-Vinci.20PCT

PCT JIRA Dashboard (Ballot and other IG Comment Tracking): https://jira.hl7.org/secure/Dashboard.jspa?selectPageId=14010

Join PCT listserv HERE. While logged into your HL7 account, expand "Da Vinci Project"in the menu on the right-hand side of the page and click "join".

Action items

  • Type your task here, using "@" to assign to a user and "//" to select a due date

Attendees

Present

Name

Affiliation

PresentNameAffiliationPresentNameAffiliation

Aditya Pattnaik

Onyx

Jackie Hemenway

UPMC

Patricia Taylor

BCBSA

Alexandra Mugge

CMS

Jacob Woodford

EPIC

Patrick Edwards

Arkansas BCBS

Akusi





Alice O'Carroll

FL Blue

James Pittman

WPS
Paul Knapp

Amol Vyas

Cambia Health

Jaime Lampshire

Cleveland Clinic

Peter Gunter

VA (Federal Electronic Health Record Management)

Andrea Preisler

AHA
Jamie FarahFL Blue
Pragya Sharma
Andrei GuselnikovEdifecs



Ankit Kumar Agarwal

@Jamie Hermansen

CMS
R Nobles

Anoop Mohemmed

Humana
Jamie ParkerAEGIS

Rachel E. Foerster

Rachel Foerster & Associates, Ltd. (RFA)

Anup

Evernorth

Jeff Helman

AEGIS

Rahul Dewal


Artem SopinEdifecs

Jeffrey Danford

Optum

Ranah Anan

Cognizant


Jeff Mincher

Texas Health Resources

Ranjith Kandur

Elevance Health
Ashley KnoxCognizant
Jennifer BoazBAH/HIIG


Ashley BarrowRE-Assist

Jennifer Thomas

MCC

Rany ElDiwany

athenaHealth

Jessica CzulewiczCMS
Rick GeimerLantana

Balaji Narayanan

Onyx

Jill Elder

Providence
Rick LisseveldAEGIS
Beth Davis
Jill SomeroMEDITECH



Bettina Vanover

Cognizant


Robert Hausam

Lantana

BenjiGraham

Bellese

Jill Vincente

Weill Cornell Medicine
Robert DieterleEnableCare

Bhargav

Jim StClair

Interoperability Institute

Ronald WamplerCVS Health/Aetna

Brian Johnson

HCA Healthcare
Joe Joseph Quinn
Ross SadlerHospital for Special Surgery

Bryan Briegel

Merative
Josh LambOptum
Ryan MoehrkeAEGIS


Josh Loria

Teton Health


Caitlin O'Donnell

Smile Digital Health
Joshua KellyFlexpa

Sam Undine

BCBSA

Caitlyn Campi

FL Blue


Sampath Jayaprakash


Carie HammondAEGIS

Kaitlin Powers

CAQH CORE

Sarah Cutcliffe

Hospital for Special Surgery
Carmen SmileyCMS/CCIIO

Karen Roswon


Savanah ArceneauxOschner Health

Celine Lefebvre

AMA

Kassie Mintesnot


Scott Haselton

Atlas

Chris Cioffi

Elevance Health

Kathy Trubisky

AultCare Insurance Company

Scott Weinberg

CMS

Chris Johnson

BCBSAL

Kayla Heath

AultCare Insurance Company

Shanna Hartman

CMS

Christol Green

Elevance

Kendra May

CMS/CCIIO

Shawn Wilson

FL Blue

Christopher Gracon

Independent Health

Kenny W

Athena Health
Sheryl TurneyElevance
Charles Porter

Kevin Day

Edifecs

Shouray

Onyx

Corey Spears

Lantana

Kevin Larsen

Optum

Soham Chakraborty

Onyx

Crystal Ponder

FL Blue


Spencer GoodwinTurquoise Health



Spencer Utley

Epic
Darcey Adams

Linda Michaelsen

Optum
Stacey DavisMcPhee

Derrin Ritchie

Point of Care Partners

Lloyd McKenzie

Dogwood

Stanley Nachimson

Nachimson

David DeGandi

Cambia

Lora Redden

Texas Health Resources

Susan Langford

BCBS TN
David DeRoodeLantana

Lorraine Doo

CMS

David Potochniak


Lynn Chapple

Optum

Taha Anjarwalla

CAQH

David Riddle

HealthLX


Tara Rose

Optum
Dawn duch*ek


Teresa McSpadden

Providence

Dawn Sprague

Cognizant
M. McFarlinFL Blue

Terrence Cunningham

AHA

Denise StClair

Global Alliant, Inc.

Madhu Madhusudana B Shivalinge Gowda


Tessa HrkalBooze Allen

Dev

Findcare (FL Blue)

Mara DiSalvo


Thomson Kuhn



Don Quackenbush



Mariel Brechner

Evernorth

Durwin Day

HCSC

Mary McKee

Turquoise Health

Tina Mintyala

Providence


Mary Kay McDaniel

Markam

Tom Frame

BCBS FL

Elissa Dines

CMS/CCIIO
Max Greenfield

Tony Benson

BCBS AL

Ellen Anderson

Evernorth

Meryl Bloomrosen

AMA

Travis Higgins


Emily Ames

CMS/CCIIO

Michael Cabral

Peraton
Tye MurphyFlorida Blue

Eric Ellsworth

Consumers' Checkbook/Center for the Study of Services
Michael MFlorida Blue


Eric RutledgeSmile Digital Health

Michael Marchant

UC Davis
Vala Rae WilliamsRohr

Erica Martin

AMA
Michelle Schreiber

Vanessa Candelora

POCP

Erin McCarthy

Florida Blue
Michele GaliotoPOCP

Viet Nguyen

Stratametrics

Ezequiel Morales (EZ)

Evernorth

Michelle Barry

Availity

Virgil Bretz

MacroHealth


Miranda Lee

Availity


Gangadhara Daka

Florida Blue
Mohan DevaragatlaFlorida Blue

Wendi Moy Akin

CMS/CCIIO

Gurbinder Singh

Humana


Wendy GerekeAEGIS






Heather McComas

AMA

Navaya Kadam

Onyx
Yalil CaraballoOptum
Heather Swartz

Nick Radov




Ingrid SaldanaHospital for Special Surgery


Zackery Welch

Providence
2024-01-17 (CANCELLED) Patient Cost Transparency Meeting - Da Vinci (2024)

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