12th Healthcare Payments Innovations

Expediting friction-free transaction flow between payers, providers, members/patients and banks to ensure speed, accuracy and cost-efficiency

February 26, 2019 to February 27, 2019

Tempe, AZ

CAQH CORE Director Erin Richter-Weber will present "Exclusive CAQH CORE Study Results" on February 26th at 9:00 a.m.

Session description:

Exclusive CAQH CORE Study Results: Applying the Lessons of FFS to Streamline Adoption of Value-based Payments

Today, as elements of value-based payments are being implemented by a growing number of stakeholders, CAQH CORE sees opportunities to strengthen the operational processes and systems supporting it. Many features of value-based payment do not align with the current fee- for-service operational system. Indeed, proprietary systems and processes for implementing value-based payment have already begun to introduce variation. Without collaboration to minimize variations, the current environment is ripe for repeating a scenario that cost stakeholders billions of dollars and slowed and complicated adoption of fee-for-service transactions. CAQH CORE conducted an 18-month study to examine value-based payment operational processes and to identify opportunity areas that, if improved, would streamline implementation of value-based payment. This presentation will detail the results of this study – a report proposing five opportunity areas associated with value-based payment including data harmonization, interoperability, patient risk stratification, provider attribution and quality measurement. Within each opportunity area, unique challenges and recommended industry- wide strategies to address each opportunity will be highlighted. 

By collaborating now, before proprietary systems and processes become entrenched in value- based payment operations, by reaching out to potential collaborators across the industry and by applying lessons learned through its success in the fee-for-service space, CAQH CORE hopes to energize an effort to ease value-based payment operational inefficiencies. 

Learning Objectives:

  • Become familiar with the challenges industry is facing in its transition from fee-for- service to value-based payments.
  • Understand the CAQH CORE study and resulting report on value-based payment operational processes and opportunity areas that, if improved, would streamline implementation of value-based payment.
  • Learn how to get involved in the effort to address the challenges contained in the five opportunity areas to ease value-based payment operational inefficiencies.


More info here.

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