Previous Year: 2021

Change Healthcare: How Will Price Transparency Engage Consumers?

Dec 7, 2021

Key Speakers:  Sheryl Zarozny, VP Consulting, and Miles Karro, Product Manager, Change Healthcare

Only in healthcare do we routinely make purchases with no idea what we are actually going to pay. That’s why pressure for price transparency for consumers is rapidly intensifying. The rule requires group health plans and health insurance issuers in the individual and group markets to provide easy-to-understand personalized information on enrollee cost-sharing for healthcare services and to publicly disclose the rates they pay healthcare providers for specific services.

In other words, we are quickly moving to a market where people can and will make informed healthcare choices based on price as one of several factors. Far from being just a burden—transparency is actually a tremendous opportunity to differentiate yourself as a healthcare leader in the 21st century.

Under this final rule, about 200 million Americans will gain access to real-time price information, enabling them to know how much their healthcare will cost them before going in for treatment. In this session, we will start with an overview of the Payer Price Transparency rules. We will cover the basics of each of the requirements, data required to be available and key dates.

• Foundational understanding of Payer Price Transparency components and deadlines
• Understanding of the required machine readable files, key content items and data governance
• View a price transparency tool that is used by many health plans and TPA’s across the country

Presentation Slides: Change Healthcare - Payer Price Transparency - Dec 2021 (pdf)

Nth Party: Unlocking Insights Without Sharing Data - The future of patient privacy through privacy enhancing technology

Dec 2, 2021

Key Speakers:  Shereen Shermak, Chief Executive Officer & Co-Founder and Andrei Lapets, Chief Science Officer & Co-Founder, Nth Party

Challenges with patient health data privacy are many; however, new technologies are emerging which unlock the potential for partners to share insights without sharing the underlying data. Use cases such as small groups of hospitals unlocking insights without sharing the underlying patient data, which remains encrypted while the analysis is performed, are possible today. Data clean rooms have been a start in this process, but modern privacy enhancing technologies make traditional data clean rooms - almost outdated. Imagine a future where many more questions can be answered, leveraging most of the data that is already available, while preserving patient privacy.

Key points include:

• Opportunities for 
• broader data collaboration to drive more accurate outcomes measurement
• better claims process optimization, using insights normally unavailable .

• Differences between data ‘clean rooms’ and privacy enhancing technologies.

• Why a privacy-preserving future is worth the investment now.

Community Care Cooperative: Journey from Start-Up to Industry Leader

Nov 2, 2021

Key Speaker:  Christina Severin, Chief Interoperability Architect and Fellow, Humana

During this webinar, you will hear about how a group of Federally Qualified Health Centers (FQHCs) joined together to start a new MassHealth Accountable Care Organization, including how they figured out how to bring together the finance needed to take ACO financial risk and how to create & operationalize a model of care.

Furthermore, you will also hear about current efforts the organization is now undertaking, including efforts to address White Supremacy and institutionalized racism, partnering with other community-based organizations to improve patient care and starting new lines of business.

• Understand how community-based organizations can work together to create scale and value
• Understand how big data supports localized population health
• Understand how large health systems and insurers can unknowingly undermine community-based primary care
• Understand upstream issues of racism in the health care system

Presentation Slides: C3ACO - Journey from start-up - Christina Severin Nov 2021 (pdf)

Humana: Moving Integrated Care Delivery Forward with FHIR

Oct 27, 2021

Key Speaker:  Patrick Murta, Chief Interoperability Architect and Fellow, Humana

In this session, we will start with an overview of contemporary health care interoperability. We will cover the basics of APIs, FHIR, and complementary technologies and the operational capabilities they bring. Examples of how other industries have used similar technologies and approaches will be high-lighted.

Once the foundation is set, we will then proceed into how the health care space is adopting the technology. We will cover how the HL7 FHIR accelerators use the FHIR ‘building blocks’ to create use cases and implementation guides. We will walk through several practical examples of using these technologies to help with real world problem such as prior authorization.

• Foundational understanding of APIs and FHIR and complementary technologies
• Understanding of how these approaches are being used across the industry to solve real world problems
• Steps for evaluating if/how FHIR should be on your roadmap

Presentation Slides: Humana - Patrick Murta FHIR Webinar October 2021 (pdf)

Pictal Health: How Visual Health Histories Optimize and Humanize Healthcare Communication

Oct 13, 2021

Key Speaker:  Katie McCurdy, Founder and Designer, Pitcal Health

The culture of healthcare is built on words: spoken, written, and typed. But in many cases, words don’t work. They can’t efficiently explain bodily sensations or lifetime journeys; they can’t sufficiently show emotions or trauma. As a result, patients and doctors often don’t understand each other, many patients aren’t getting the right diagnosis and treatment, and doctors are burning out.

Visuals can help.

Pictal Health, founded by patient and designer Katie McCurdy, is the first company to help people with rare, complex, and mysterious health issues tell their stories visually – helping them be heard and understood as they work with their doctors.

In this session Katie will share surprising insights about what she has gained from helping over 55 patients visualize their health history and symptoms. She’ll detail the unique types of data she collects and visualizes – data that isn’t found in our health records today – and she’ll discuss how these visuals have helped clinicians and patients alike. Learn more at katiemccurdy.com and pictalhealth.com.

Key points include:

• Learn why our current means of healthcare communication causes cognitive strain for both patients and doctors
• Understand why visual health history and symptom communication supports better storytelling and cognition
• See what kinds of data are vital to a patient’s “whole story”
• Learn about a unique process of collecting the patient’s whole story that helps them be fully heard

Imprado: A Comprehensive Approach to Health Care Transformation: A Framework for Success

Oct 7, 2021

Key Speaker:  Alix Goss, Vice President and Senior Consultant, Imprado

In this webinar, Alix Goss will share her insight and expertise acquired from her 30+ years as a leader in the industry.  Her leadership roles include developing national health care standards, implementing and complying with federal and state regulations, and aligning business strategies, systems integration and operations management in both private and public sectors.  Alix is passionate about enabling healthier and more productive people by strengthening organizations, public policy and national standards. She was appointed to and served on the National Committee on Vital and Health Statistics, the public advisory body to the Secretary of Health and Human Services for health data, statistics, privacy, and national health information policy and the Health Insurance Portability and Accountability Act. Recognized for her involvement and leadership of game-changing initiatives to improve the United States health care system’s efficiency and outcomes, Alix received WEDI’s Louis Sullivan Award honoring individuals who have distinguished themselves through their leadership, vision and achievements in advancing the efficiency of health care.

Alix will present the Imprado health care transformation framework for success, comprised of five categories: business, technology, policy, process & governance, and culture & environment. The framework provides context for: 1) organizations to mindfully design and iterate plans post-COVID to address policy and technology opportunities resulting from 21st Century Cures-related regulations, public health modernization and equity barriers and 2) innovating approaches to patient, caregiver and community engagement essential to improving health care outcomes. 

Key points include:

• Learn the five categories that influence nationwide interoperability and the interplay between them
• Understand the re-usability of the framework on the never-ending journey to improve health care outcomes for all citizens
• Recognize challenges and opportunities of a patient centric approach to bridge from current technology to new technology and innovative models
• Appreciate the value of “the village” it takes to improve health care for all

The CARIN Alliance: Advancing Digital Identity, Authentication and Federation

Sept 30, 2021

Key Speaker:  Ryan Howells, Principal at Leavitt Partners

The only constant in health care is the individual enrolling in coverage or receiving care. Therefore, CARIN supports “person-centric” digital identity credentials, where an individual has a portable, high-assurance digital credential they can use to control when and how their personal information is shared across systems. The individual person becomes the “single source of truth,” and regardless of whether the information is out of date, it’s still unique to the individual and the individual can use that same digital identity credential whenever they log in to a new system.

The CARIN Alliance seeks to advance an equitable and more efficient health care experience by allowing individuals the ability to create, manage, and use their own digital identity, and then voluntarily use that digital identity across multiple systems to provide a more seamless and robust experience for themselves and their families. CARIN has worked with HHS, CMS, and the ONC along with multiple trust framework organizations over the last couple of years to create a digital federated trust agreement that allows for a marketplace of trust framework organizations to support a common policy framework so multiple identity providers can be trusted by multiple relying parties. We believe federating digital identity is a many-to-many problem, needs a marketplace of solutions, and requires a public/private partnership to help it scale.

Presentation slides: CARIN_Digital_ID_09302021 (pdf)

HealthDataViz: Design Thinking for Health and Healthcare Data Visualizations

Sept 14, 2021

Key Speaker:  Kathy Rowell, Co-Founder, HealthDataViz

Approaching a data visualization project can feel like being trapped in a carnival house of mirrors—those maze-like puzzles that are designed to confuse people in unusual, humorous, sometimes frightening, even paralyzing ways that visually distort and cloak the unobstructed path through and out.

But creating data visualizations does not have to feel that way. Establishing a process grounded in user-centered requirements gathering and design thinking concepts and methods helps illuminate the path toward useful, understandable, visually pleasing data displays.

In this webinar Kathy will describe the design-thinking process for creative problem-solving that is human-centered, empathetic, collaborative, experimental, and optimistic. She will also use relevant health and healthcare data visualization projects to demonstrate how the five-design thinking foundational concepts – empathize, define, ideate, prototype and test -- provide the structure teams need to create clear and compelling dashboards, reports and multidimensional exploratory displays (MEDS™) that people love to use.

CMS: CMS Interoperability Updates

Aug 24, 2021

Key Speaker:  Alexandra (Alex) Mugge, MPH, Director and Deputy Chief Health Informatics Officer, CMS

Lack of seamless data exchange in healthcare has historically detracted from patient care, leading to poor health outcomes, and higher costs. The Centers for Medicare and Medicaid Services (CMS) has established policies that break down barriers in the nation’s health system to enable better patient access to their health information, improve interoperability and unleash innovation, while reducing burden on payers and providers.

Through these regulations, patients and their healthcare providers will have the opportunity to be more informed, which can lead to better care and improved patient outcomes, while at the same time reducing burden. In a future where data flows freely and securely between payers, providers, and patients, we can achieve truly coordinated care, improved health outcomes, and reduced costs.

Key points include:

• Hear about how CMS is making progress towards an interoperable healthcare system that increases access to data and reduces burden.
• Learn about the CMS Interoperability Rules that will drive change in how clinical and administrative information is exchanged between payers, providers and patients, and will support more efficient care coordination.
• Understand the CMS Interoperability API Requirements and next steps related to the future of healthcare interoperability.

Presentation slides: Alex Mugge - CMS Interoperability Updates (pdf)

Cambridge Health Alliance: Granular Data Segmentation to Protect Privacy and Promote Equitable Interoperability

Aug 17, 2021

Key Speaker:  Hannah K. Galvin, MD, FAAP, FAMIA, Chief Medical Information Officer, Cambridge Health Alliance

Our discussion focuses around the ability to share patient information between clinical providers, family members/caregivers and other entities meaningfully improve the care of individuals and the health of communities. When a patient has data they consider to be sensitive in their medical record, they may wish to control how such data gets shared; state and/or federal law may also protect the sharing of specific sensitive data as a means to preserve the integrity of the patient-provider relationship.

Key points include:

• The ability to share patient information between clinical providers, family members/caregivers and other entities is essential to the provision of good care; in many cases, NOT sharing certain information with specific individuals is just as essential to providing optimal care.
• Lack of widespread implementation of technical standards for granular segmentation of data has led to the adoption of blunt algorithms which may result in care inequities.
• The Protecting Privacy to Promote Interoperability (PP2PI) Workgroup seeks to address this issue by bringing together multidisciplinary stakeholders across the industry to revise standards and develop consensus-driven implementation guidance, in order to support future policy.

Presentation slides: Dr Galvin (CHA) - Granular Data Segmentation (pdf)

Hooper, Lundy & Bookman: Owning an Opportunity - Digital Health Developments for 2021

Jun 10, 2021

Key Speaker:  Amy Joseph, Co-Founder, and Jeremy Sherer, Chairman Digital Health Practice, Hooper, Lundy & Bookman, PC

The COVID-19 pandemic initiated unprecedented growth across the digital health space from patient utilization to regulatory progress to outside investment and beyond. This confluence of events created a unique window of opportunity for digital health stakeholders to innovate in ways that will shape a new digital health landscape for years to come. This presentation will explore the legal developments underpinning some of the important trends that will impact digital health companies and healthcare providers alike.

Key points include:

• Understanding the state of affairs concerning clinical practices utilizing digital health technology in Massachusetts after significant developments in 2020 and early 2021;
• How waivers and expanded coverage of digital health services implemented during the pandemic will (and will not) remain in place;
• Opportunities available to digital health companies and providers as a result of recently adopted federal fraud and abuse regulations focused on value-based arrangements.

Presentation slides: Hooper, Lundy & Bookman: Owning an Opportunity (pdf)

Intersystems: Why Maintaining Provider Information Shouldn't Be So Hard

May 11, 2021

Key Speaker:  Jessica Jowdy, Lead Sales Engineer, and Lynda Rowe, Senior Advisor for Value-Based Markets, Intersystems

Everyone involved in maintaining provider information probably knows how challenging it can be. However, when you look at the numbers, 25% of provider data changes annually, the real complexity can be daunting. Yet poor data can lead to operational inefficiency, problems with revenue collection, and more importantly patient dissatisfaction. 

Key points include:

• Some of the challenges in keeping provider information up to date
• How providers, payers and patients benefit from a single-source-of-truth provider directory
• Overview of how provider directory manages the lifecycle of key provider data

Presentation slides: Intersystems: Maintaining Provider Information Presentation (pdf)

3Analytics: COVID Vaccine Safety: Allaying Safety Concerns, Reducing Vaccine Hesitancy, and Saving Lives With Real-time Analytics and Risk Communication

May 11, 2021

Key Speaker:  Dr. Dharani Gokul Munirathinam, Co-Founder & Chief Scientific Officer, 3Analytics

While COVID vaccinations are ramping up across the globe, no active surveillance of COVID Vaccine Adverse Events (AEs) exists. This lack of real-time surveillance increases vaccine hesitancy and mistrust. Even the World Health Organization is in search of a solution for multiple countries. 3 Analytics has been shortlisted by WHO for a global roll out of Active Surveillance for COVID Vaccine AEFI.

Key points include:

• Why active surveillance of COVID vaccine adverse events is important
• Why old ways of managing safety will not work in this COVID era
• Lack of pharmacovigilance systems in multiple countries to handle Covid vaccine safety
• The challenges in active surveillance of Adverse events following Covid vaccination
• The links between vaccine chemistry and adverse events
• How to proactively avoid allergic reactions from covid vaccines
• How to learn which vaccine is safer for you
• What do in case of an adverse event and how to reduce overall risks in vaccination campaigns
• How to fight fake news
• How to be prepared for future Pandemics if any

Presentation slides: 3Analytics: COVID Vaccine Safety (pdf)

Mettle Solutions: Increasing Standardization in the Prior Authorization Process

May 6, 2021

Speaker: Melanie Combs-Dyer, Director of Innovation, Mettle Solutions

In its Fall 2020 proposed interoperability regulation, the Centers for Medicare & Medicaid Services (CMS) proposed to require several types of payers to develop and maintain a Documentation Requirement Lookup Service (DRLS) using a format called Fast Healthcare Interoperability Resources (FHIR). In addition, CMS proposed to require certain payers to accept prior authorization requests in FHIR format. A group of payer and IT vendor volunteers has formed an HL7 workgroup called the Uniform Elements for Prior Authorization. Chaired by Melanie Combs-Dyer, the Director of Innovation at Mettle Solutions, the workgroup meets weekly in an attempt to increase standardization across payers’ prior authorization elements. Melanie Combs-Dyer, who spent 30 years working at CMS, will gives a talk describing the DRLS vision and discussing the activities of the Uniform Elements for Prior Authorization workgroup.

Key points include:

• A description of a Documentation Requirement Lookup Service (DRLS)
• Understanding how payer DRLS systems can help reduce provider burden
• Seeing how DRLS adoption could pave the way to more/better patient cost transparency
• Hearing about the activities of the Uniform Elements of Prior Authorization workgroup

Presentation slides: Mettle Solutions: Increasing Standardization in the Prior Authorization Process (pdf)

Build or Buy - Delivering Acute Care at Home (Purpose-Built: Bringing the Virtual Hospital to the Home)

April 8, 2021

Speaker: Raphael Rakowski, Executive Chairman, Medically Home

In this presentation, we explore the change management required to adopt Acute Care at Home and the critical components needed to expand the model to multiple use cases and populations.

Key points will include:

• How is the target patient population changing with Covid and new consumer preferences? What does the future hold?
• What are the essential elements of the virtual acute care model?
• How does the model have the potential to scale? Multiple use cases and populations served?
• What is the economic outlook for virtual hospital models?
• What are the reimbursement models from payers and CMS?
• Is there a first-mover market advantage to offering inpatient-level acute care at home?

Presentation slides: Medically Home: Build or Buy - Raphael Rakowski (pdf)

Interoperability: Going Beyond Compliance; A Consumer Centric Approach

March 31, 2021

Speakers: Tammy Graves, Principal, Point B and Susan Yeazel, Customer Director, Point B

In this presentation, Tammy Graves and Susan Yeazel will discuss how payers and providers can move beyond “checking the box”  to be compliant with this new regulation and accelerate their organizations customer experience consistent with the spirit of the regulation.

Key points will include:

• Why compliance is only table stakes
• Why you should leverage the regulation to accelerate your customer experience
• How to take specific next steps to move beyond expectations of the regulation

Presentation slides: Point B - Interoperability Solution (pdf)

The Accelerating Shift to Value Based Care

March 18, 2021

Speaker: David P. Terry, MBA, Co-founder, Chief Executive Officer, Archway Health

The shift from volume to value is about to accelerate significantly due 4 major drivers. This webinar will describe each of these drivers and discuss the impact they will have on providers, payers and patients over the next few years. 

Key points will include:

• Details about the Direct Contracting program and recent updates to Stark laws;
• How COVID-19 and other factors are driving increased provider demand for VBC contracts;
• How provider performance data is being used to change networks;
• Scenarios for how the accelerated shift to value is shift could disrupt the healthcare landscape

Presentation slides: Archway Health - The Accelerating Shift to Value Based Care (pdf)

A Patient Safety "Early Warning" System: Getting the Complete Picture

March 11, 2021

Speaker: Robert Hanscom, Vice President of Risk Management and Analytics, Coverys

This presentation will highlight a methodology whereby the ‘signals’ from malpractice can pose critical questions, and then drive responsive actions. 

Additionally, we will explore how the integration of malpractice insights into a central core of intel has the potential of transforming how healthcare can better predict – and proactively prevent – medical errors and poor outcomes.

Presentation slides: Coverys - Patient Safety "Early Warning" System (pdf)

Tackling the Operational and Cultural Challenges of the Information Blocking Rule

February 23, 2021

Speaker: Adam Greene, Partner in Washington, D.C., Davis Wright Tremaine, LLP.

Key discussion points:

• Understanding the 21st Century Cures Act Information Blocking Rule and what must be done by its April 5, 2021 applicability date
• How to identify, analyze, and remediate potential information blocking practices
• Addressing the cultural challenges among clinical staff and others regarding unfettered access to electronic health information
• Open questions about the Rule that remain unanswered

Presentation slides: Tackling the Operational and Cultural Challenges of the Information Blocking Rule (pdf)

ACT | The App Association: Shifting Privacy Laws and Health Data: An Overview

February 2, 2021

Speaker: Graham Dufault, Senior Director for Public Policy, ACT | The App Association

From new federal Department of Health and Human Services rules to recently-enacted state laws, privacy mandates are imposing a shifting set of requirements on companies that collect and process healthcare data. And the development of data-driven tools to target COVID-19 and mitigate its spread has intensified the spotlight on the nexus between how traditional healthcare companies are regulated versus the activities of tech-driven firms outside the “HIPAA umbrella.”

This presentation will cover three main topics:

1) the state of federal privacy laws and their relationship to healthcare data

2) state level privacy activities (California, mostly)

3) federal proposals and congressional activity

Presentation slides: Shifting Privacy Laws and Health Data: An Overview (pdf)