Administrative Simplification
The mission of this workgroup is to implement coordinated, improved, simplified claims administration and other procedures to reduce admin costs by looking at these potential areas: 1) maximizing the electronic claims process; 2) simplifying EOB and patient bills; 3) creating uniform provider credentialing; 4) improving the efficiency of claims adjudication 5) evaluating the effectiveness of the prior authorization process, and 6) identifying specific provider reporting requirements, forms, etc., that are redundant and can be eliminated or modified and still comply with different state agencies and/or payers.CHAIR: Carl Callison, Mountain State Blue Cross Blue Shield
Chronic Care - HIT
The mission of this workgroup is to provide access to a comprehensive inter-operable health information system for all West Virginia providers, hospitals and insurers by developing a statewide, integrated, inter-operable electronic health information infrastructure and moving health care providers toward adopting electronic records by date certain.CHAIR: James L. Comerci, M.D., The Upper Ohio Valley Individual Practice Association
Health System Redesign
The mission of this workgroup is to build a new delivery system designed to provide state-of-the-art access to care for all West Virginians with a regional structure that is linked statewide by developing strategies to promote quality healthcare as well as other strategies to manage primary health care delivery; developing community level implementation strategies for the deployment of a chronic care delivery model (s); and developing provider models (FQHC, family practice doctors, nurses or others) that provide timely care for those with health needs.CHAIR: Tom Susman, TSG Consulting
Wellness & Health Promotion
The mission of this workgroup is to devise a plan to help reduce the level and growth of obesity, improve wellness and promote health in the state over the next 5-10 years by targeting schools, communities and the workplace (ie. establish promising and effective approaches in these settings to increase physical activity, increase fruit and vegetable consumption, reduce smoking, etc.)CHAIR: Keri Kennedy, WV Office of Healthy Lifestyles