June 2017

CAQH Convenes Alliance to Improve Accuracy of Healthcare Provider Data

June 2017

CAQH has convened a cross-section of healthcare leaders to improve the accuracy of provider data for both industry stakeholders and patients. The Provider Data Action Alliance will develop a roadmap that articulates a vision and actionable strategies for obtaining and sharing better information. Alliance participants represent health, dental and vision plans; provider organizations; health systems; government; and health information exchanges.

The Alliance was a result of the 2016 Provider Data Summit, a CAQH-hosted conference where more than 100 industry leaders met to discuss provider data challenges. Attendees reached agreement on the priorities for improving provider data and called for further industry-wide collaboration. Summit discussions were informed by a white paper created by CAQH with support from Manatt Health, a leading health policy and research firm.

Now Online: 2016 CAQH Annual Report

June 2017

The newly available 2016 CAQH Annual Report outlines the many accomplishments of the organization that support its mission of streamlining the business of healthcare. For those who may only know CAQH through experiences with a specific solution or initiative, the report provides the opportunity to learn more about the full breadth of CAQH activities.

CAQH Again Named Best Place to Work in Healthcare

June 2017

For the second year in a row, CAQH has been named by Modern Healthcare as one of the Best Places to Work in Healthcare for 2017. The program recognizes 100 organizations and companies nation-wide for the ability to “empower their employees to provide patients and customers with the best possible care, products and services.”

Provider-Owned Health Plans Awarded CORE Certification

June 2017

Boston Medical Center Health Plan, Providence Health Plan and UPMC Health Plan have completed testing and been awarded CORE certifications for Phases I-III of the CAQH CORE Operating Rules. Organizations in this rapidly growing part of the new healthcare economy are seeking CORE Certification to go above and beyond regulatory requirements and improve electronic data sharing.

According to a report by McKinsey & Company, today more than 15 million people are covered by provider-owned insurance plans in 39 states, and that number is growing. These plans combine both medical claims and clinical data enabling them to achieve economies of scale, manage risk and improve population health.

CORE Certification supports these goals by ensuring they exchange administrative data securely, accurately and efficiently.

Gwendolyn Lohse Named One of Most Powerful Women in Healthcare IT by Health Data Management

June 2017

CAQH Deputy Director and CAQH CORE Managing Director Gwendolyn Lohse has been named by Health Data Management as one of the 2017 Most Powerful Women in Healthcare IT, in the thought leader category. The award recognizes women in the field of healthcare IT who have made valuable contributions to advancing the industry.

Lohse has been with CAQH since its inception. She played an instrumental role in bringing the important concept of operating rules to the healthcare industry and in creating CAQH CORE, the Committee on Operating Rules for Information Exchange, the industry-wide alliance that led to their development and wide-spread adoption. More than 130 organizations – including health plans, hospitals and health systems and IT vendors – have joined CAQH CORE.


CAQH CORE Town Hall Webinar

June 20, 2017, 2:00 PM ET

CAQH CORE Town Hall webinars provide the public with an update on recent activities related to industry development and/or implementation of healthcare operating rules. Learn about federally mandated and voluntary CAQH CORE Operating Rules, voluntary CORE Certification and much more. Register now

2016 CAQH Index: Tracking Industry Trends and Cost Savings in Use of Electronic Healthcare Business Transactions

June 28, 2017, 2:00 PM ET

There is widespread consensus that administrative costs in healthcare are excessive. By some estimates, more than $31 billion each year is spent conducting basic business transactions between healthcare providers and health plans. Much of this expense can be attributed to resource-intensive manual processes, such as phone calls to verify patient coverage or mailing claims and paper checks. Learn how the CAQH Index tracks industry trends in the adoption and cost savings of electronic healthcare business transactions. Register now.

CAQH on the Road

CAQH will be exhibiting or speaking at the following events:


Value-Based Care Summit, Chicago
June 22
Presentation (3:15-4:00 p.m.): “Transitioning to New Payment Models – Lessons Learned from Implementing National Business Rules for Administrative Data Exchange”

Academy Health 2017 Annual Research Meeting, New Orleans
June 26
Poster Presentation B (8:00-9:15 a.m.): “Measuring the 2016 CAQH Index: Impact of Recent Industry and Regulatory Efforts to Increase Automation of Routine Healthcare Administrative Transactions”

Western Operations Conference (Arkansas Blue Cross and Blue Shield), Snowbird, Utah
June 25-28
Visit the CAQH exhibit booth.


New CAQH Staff

Antoinette Cummins, Senior Provider Engagement Manager

Antoinette is responsible for increasing provider adoption and engagement across CAQH solutions. She has more than seven years of healthcare and strategic marketing and communications experience. Prior to joining CAQH, Antoinette was associate director of marketing operations at Evolent Health.

Christos Droukas, Operations Support Specialist

Christos supports operations in the daily execution, monitoring and enhancement of CAQH solutions. He holds a degree in environmental studies from the University of Washington.

Rachel Goldstein, CORE Manager

Rachel is supporting CAQH CORE projects, including Attachments, Prior Authorization and various maintenance activities. She previously worked at Deloitte Consulting with government clients from the Internal Revenue Service (IRS) – Affordable Care Act Program Management Office, the CMS Innovation Center and the Department of Veterans Affairs.  

Ola Owoyemi, Sr. Business Analyst

Ola is the newest member of the CAQH Business Analysis Center of Excellence. She has held positions at the Coleman Group where she was a business analyst and GBK Consulting in Washington, D.C. 

Omar Rabb, Major Account Manager

Omar is managing multiple member plans and several large key accounts for CAQH. Most recently, he served as a business relationship executive at DocASAP. Omar has more than nine years of healthcare client relationship management experience.  

Katie Werner, HR Generalist

Katie works focuses on recruitment and performs general human resources duties. She joins CAQH from MedStar Georgetown University Hospital where she was a recruiter. She is a graduate of James Madison University. 

Cyndi West, Managing Director, Business Development and Account Management

Cyndi will be overseeing and providing strategic guidance for business development and account management. She has many years of experience building sales teams, implementing Customer Relationship Management systems and managing call centers. Prior to joining CAQH, Cyndi was VP Sales and Marketing for Truven (IBM Watson), with responsibility for managing a team of 160 sales professionals and 20 account managers selling into the payer, provider and hospital markets. Prior to joining Truven, Cyndi was a consultant in sales and account management to the payer community, working with health plans.

CAQH in the News

86% of Providers Saw Prior Authorization Requirements Increase – RevCycleIntelligence

RCM tip of the day: View provider enrollment as a critical part of your revenue cycle – Becker’s Hospital CFO Report

3 ways software streamlines today’s dental offices – Dentistry IQ

Best Places to Work in Healthcare-2017 – Modern Healthcare

Yuvi Kochar Named Managing Director of Technology and Operations at CAQH – Washington Business Journal

Four Ways to Boost Dental Practice Profitability – Dentistry Today

Interoperability: Beyond the Clinical Side of Healthcare – The American Journal of Managed Care

Guide to Optometry Residency Preparation – New Grad Optometry.com

The Most Powerful Women in Healthcare IT for 2017 – Health Data Management

Provider-Owned Health Plans Adopt Interoperability Standards – HealthPayer Intelligence

Achieving a Paper Free Healthcare System – Availity Blog

CAQH software aids payer credentialing efforts – Health Data Management

Four Ways Going Paperless Helps Your Business – Inside Indiana Business