Healthcare IT Interoperability, EHR interoperability, Hospital Interoperability

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Payers to Focus on Price Transparency, Data Exchange at HIMSS19

The 2019 HIMSS Conference will feature sessions on price transparency, administrative burdens, and how payers can better exchange health data.

Payers to focus on price transparency, data exchange at HIMSS19

Source: Thinkstock

By Jessica Kent

- Price transparency, data exchange strategies, and the challenges of addressing administrative burdens will be among the key discussion topics for payers at this year’s HIMSS Global Conference and Exhibition in Orlando, Florida.

Over 45,000 health IT professionals, clinicians, and executives will gather at the Orange County Convention Center in February to discuss innovative solutions to some of healthcare’s biggest problems.

Many of these discussions will center around the role of payers in interoperability and health data exchange, with HIMSS offering a special full-day program called the Interoperability and HIE Symposium.

Several of the industry’s major players will examine these evolving technologies and evaluate how payers can use these tools to drive changes in healthcare, including streamlining processes and reducing costs.

In a Monday afternoon session, Kari Hedges, Senior Vice President of Commercial Markets and Enterprise Data Solutions at Blue Cross Blue Shield Association (BCBSA), and Thomas Novak, Medicaid Interoperability Lead at ONC, will discuss how health information exchanges (HIEs) can engage the payer community in sharing clinical data.

The session will identify valuable data sharing use cases for payers and discuss the different types of data HIEs can receive from payers. Speakers will also address challenges and best practices for engaging payers in HIEs.

Later that week, Melanie Combs-Dyer, health insurance specialist at CMS, and Steven Lane, MD, Clinical Informatics Physician Director at Sutter Health, will lead a panel discussion on the automation of information exchange between providers and payers. The speakers will focus on how to unlock critical patient information that providers need from their payer partners.

Also in this session, members of the HL7 Da Vinci Project will talk about the real-world progress they have made in reducing administrative burden and improving the patient experience.

CEOs from Blue Cross Blue Shield will share their interoperability best practices as well. In a late-morning session on February 14, Dan Hilferty, CEO of Independence Blue Cross, JD Hickey, MD, President and CEO of Blue Cross Blue Shield of Tennessee, and others will share use cases that demonstrate the potential for seamless information sharing to reduce costs.

Speakers will also address the current challenges of sharing health information across the healthcare ecosystem and define the key innovations necessary to advance interoperability.

The conference will also spotlight blockchain’s emerging role in reducing administrative costs and burdens.

Jason O’Meara, Senior Director of Architecture at Quest Diagnostics, and Kyle Culver, Principal Blockchain Architect at Humana, will provide an overview of the Synaptic Health Alliance, a blockchain collaborative between Humana, Quest Diagnostics, and other major industry names.

The panel will explore how blockchain can improve the accuracy of provider directory data highlight the current challenges of provider data exchange.

Price transparency will also factor into the interoperability discussion.

On Tuesday, Andrew Mellin, MD, VP of Medical Informatics Physician at Surescripts, and Lynne Nowak, MD, VP of Provider Solutions at Express Scripts, will lead a conversation about how interoperability is providing physicians with accurate patient information at the point of care and driving a breakthrough in prescription price transparency.

Session leaders will examine new data that shows how increased price transparency is resulting in greater efficiency, reduced costs, and increased satisfaction.

In addition to interoperability and health data exchange, the conference will also highlight data integration.

A session led by Nils Fischer, Senior Analyst at Partners Connected Health, and Mariana Simons, PhD, Senior Data Scientist, Chronic Disease Management Department, Philips Research, will describe how electronic health record (EHR) data integration can provide insight into patient health status.

The speakers will detail how data integration can help organizations analyze the differences between patients in different cost segments. The session aims to explore how focusing on middle-cost segment patients, rather than top-cost patients, can drive healthcare saving and prevent avoidable hospitalizations.

Joshua Riff, MD, CEO of Onduo, and Mark Talluto, Vice President of Strategy and Analytics at BCBSA, will lead a discussion about how payers can combat the diabetes epidemic by combining innovative technology and strategic partnerships. The panel will demonstrate how collaboration and patient engagement tools can improve patient outcomes.   

With over 300 education sessions spanning 24 topics, HIMSS 2019 promises to offer a comprehensive overview of the current state of the industry, as well as a helpful glimpse into its future.

This year’s sessions highlight the fact that as healthcare becomes increasingly digital and data-driven, the role of payers will follow suit.


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