NPAG 2006 Conference
EDI Uncorked: Beyond Administrative Transactions
Napa Valley , CA

The 2006 National Plan Automation Group (NPAG) Conference was held last April in Napa Valley, California and attended by over 100 BCBS Associates representing 35 BCBS plans. The theme of the conference, "EDI Uncorked", was moving EDI beyond the cost savings associated with the adoption of administrative transactions to exploring how our existing EDI networks can be used to support clinical information exchange, such as Payer-Based Health Records, and clinical transactions, such as E-Prescribing and E-Lab, to improve the quality of healthcare while reducing the clinical cost of care.

The first day of this year's conference focused on the clinical applications. The keynote address was given by Jeffrey Rideout, MD, Cisco Systems VP Internet Healthcare Group and Corporate Medical Director. As a former Blue Shield of CA CMO, Dr. Rideout focused on why enabling electronic healthcare transformation was essential from the health plan's perspective.

Following the keynote, breakout sessions included Payer-Based health records, E-Prescribing, electronic medical records and RHIOs. Dr. Robert Mirsky, Senior Medical Director, BCBS of FL and Dr. Christopher Valerian CMO, Horizon BCBS of NJ discussed how their plans benefited by implementing payer-based health records with Julie Klapstein, CEO of Availity acting as the moderator. The E-Prescribing sessions also focused on plan implementation and the benefits realized by two Blue plans; BCBS of MA presented by Vincent Plourde, VP Provider Services and Carefirst presented by Peter Stoessel, Director Medical Systems and Business Development.

Electronic medical records and RHIOs were presented by Dr. Peter Geerlofs, CMO, AllScripts and Tom Boehning, McKesson, VP Group Practice Solutions. Integrated Healthcare's Tom Williams discussed pay for performance and performance modeling with NCQA's VP of Product Development Phyllis Torda. The afternoon general session was a health information data exchange forum discussion with CalRHIO CEO Lori Hack and Dr. Sophia Chang, Director, California Health Care Foundation, with Dr. Eric Book, CMO, BS of CA, moderated by Dr. Giff Boyce-Smith, Senior Medical Director, Blue Shield of CA

During the luncheon, NPAG recognized the 40 vendors in attendance, some of which have been supporting NPAG since its inception in the late 80s. NPAG would not be possible without the support of our vendors. Blue plans find it is a great way to survey the current vendor landscape while the vendors have several opportunities to spend significant time with many customers and future prospects. Except for the BCBS Association Update and Plan Share, all presentations and events were open to both attendees and exhibitors. As in years past, the Napa conference encouraged all the attendees to visit each vendor's booth to understand the products and services available to the Blue plans in attendance. This year we sold all 40 booths available and the NPAG Steering Committee decided it should restrict vendor participation in future conferences to 40 vendors to make sure everyone benefits. All 220 participants were treated to a special dinner and reception at the Niebaum-Coppola Winery complements of Edifecs.

The second day began with the general session presentation, 100% Self Service from, Steven Wiggins, CIO BCBS of SC. Steve went through the initiatives that have allowed the South Carolina Plan to automate virtually every provider's transaction and interaction with the health plan. This was followed by a panel discussion around the issues regarding enabling the interoperability of transactions. Panel members included Jim Swanson, Director NE Region EDI Operations of Wellpoint; Dan Kazzaz, X12 Standards Chair and Durwin Day, EDI Manager of HCSC moderated by Sunny Singh, CEO of Edifecs.

The afternoon activities of golf and wine tours for attendees and exhibitors were scheduled but the golf had to be cancelled due to unusually heavy rain. Attendees and exhibitors enjoyed an evening party, dessert reception and dance all provided by exhibitor sponsorship.

The final day began with an introduction of the 2007 conference in Chicago hosted by BCBS of IL. The BCBS Association update and IT strategy by Rich Landen was presented next and in this closed session Rich updated the Blue plans with news from the Association regarding numerous initiatives and policy updates. Doug Spence, COO of Foresight moderated the final general session on the Transition to NPI. This was one of the most lively discussions and included presentations by Andrea Danes, the CMS NPI enumerator contractor from Fox Systems. Susan Warren from BCBS of AL described how her plan is implementing NPI as did Alan Bagby, BCBS of KS. Nancy Reed from THIN commented on NPI implications for the clearinghouses.

The conference ended with a closed Plan Share session and the continuation of the NPI issues that were raised in the last general session. Plan Share is an open discussion between Blue plans to learn from the shared experiences of each plan. The conference began with an initial Plan Share to begin discussions on successes, failures and lessons learned, followed by the opening wine and cheese reception, sponsored by Availity. In the opening Plan Share, there were presentations by BCBS of FL and their experience with Availity, and by BCBS of TX and their experience with THIN. Other Blues were encouraged to provide information regarding their lessons learned during this session.

We ended NPAG with a Plan Share to have a final discussion on any issues raised during the conference and hear brief presentations from Joel Hasenwinkel from Wellmark on their work pursuing quality improvement from obtaining data from clinicians. Joel discussed lessons learned from early pay for quality performance initiatives and the challenge of capturing data that already exists in electronic format. Dennis Morisette from BCBS of IL discussed his plan's paper reduction actions to achieve 86% EDI from 68% over a 3 year period. Dennis reviewed how they reduced paper, minimized duplicates and removed internal barriers, including eliminating attachment requirements.

We all look forward to meeting again in Chicago in the fall of 2007.

- Jim Hoey
Blue Shield of California
2006 Host Plan