National Uniform Claim Committee/National Uniform Billing Committee
February 26, 2014
Prepared by Barbara Rudolph, PhD., NAHDO Consultant
The NUCC/NUBC Joint Meeting took place in Baltimore, MD., February 26th. The first topic was focused on Alternative Payment Models, with presentations from WEDI, CMS, and Mayo Clinic. This was followed by reports from the NUCC ACO Subcommittee, the WEDI UDI Workgroup, and an open discussion regarding topics for the July Joint Meeting of the NUCC/NUBC.
NUCC/NUBC Joint Meeting
I. Presentations from Organizations Doing Alternative Payment Models Today (See NUCC website for copies of presentations)
a. Industry Work presented by WEDI
i. Ms. Samantha Burch, Federation of American Hospitals, provided an overview of work done by WEDI for the 2013 Annual WEDI Report. She discussed an overview of the attributes and types of alternative payment models, barriers to participating, and expectations for the future with alternative payment models.
ii. Samantha Holvey from WEDI discussed WEDI work on alternative payment models, which includes a Webinar Series that took place in January and March. In addition a summit was held in March in Chicago. Committee members were invited to attend the summit.
b. Payer Perspective presented by CMS
i. Adam Conway from CMS CMMI office presented on the four Medicare alternative payment models in the current demonstration project. He provided an overview of the different models and their different scopes of service.
c. Provider Perspective present by Mayo Clinic
i. Ms. Darst provided a brief overview of work being done at Mayo on alternative payment models. At this time they are engaged in two bundled payment arrangements. One is for transplant billing; the second is with BCBSMN on a bundled payment for knee replacement. Mayo has identified a need for transaction solutions in order to send all services on one claim. They also indicated the need for a data collection solution for these new payment alternatives, given that, at this time, the data collection is manual and takes significant staff time to gather all of the information. The entire structure needs automation.
II. Report from the NUCC ACO Subcommittee and Discussion
a. Miss Spector, AMA, gave an overview of the work being done by the subcommittee. Their work initially focused on building a transaction workflow for alternative payment models. It became apparent that the amount of diversity in these types of arrangements made such an effort impossible. As an alternative they made a list of the types of alternative payment models in place and had a discussion about each.
b. Next, the NUCC had a discussion on various identified concerns related to alternative payment models. The need for linkage of the professional and institutional claims was expressed. The committee discussed that most providers are not prepared to handle the information for participating in an alternative payment model. It was suggested that the committee look at various models for commonalities and look at what needs to be done to support those efforts.
c. The following next steps were identified:
i. Committee members were encouraged to participate in WEDI’s work
ii. Committee members were asked to obtain feedback from participants in models to understand more about their functions and needs.
iii. This topic should be added to the July Joint Meeting.
III. WEDI Unique Device Identifier (UDI)
a. Samantha Holvey from WEDI provided an overview of the work being done by WEDI on UDI. WEDI received a grant to develop a white paper on how to capture and report the UDI. WEDI held several meetings of stakeholders and a Technical Advisory Committee, which provided feedback. Ms. Holvey reported that the White Paper was being drafted.
b. Mr. Arges reported that the NUBC discussed the issue of the UDI during their meeting. The NUBC agreed to write a letter expressing its concerns about reporting UDI on the claim; letter can be found at: www.nubc.org/aboutus/PDFS/NUBC_UDILetter-final.pdf NUCC members have agreed to also draft a letter expressing their concerns.
IV. Open Discussion
a. There was a general discussion about topics for the July meeting. The Committee would like an update on the UDI and alternative payment models. They would also like to discuss operating rules for claims and HPID.