Table of Contents
    Section                                  Summary
    Background                               •  2016 Provider Data Summit Purpose and Outcomes.
                                             •  Provider Data Action Alliance Participants and Objectives.
                                             •  Key Questions for Discussion.
    Industry Roadmap for Provider Data       •  Underlying Causes of Current Issues in Provider Data.
    Draft Summary                            •  Core Principles for a Healthy Provider Data Ecosystem.
                                             •  A Vision for Provider Data.
                                             •  An Industry Strategy to Implement the Vision.
    Achieving Industry Support               •  Review of, and comment on, the Draft Roadmap or Summary.
                                             •  Roadmap Endorsement and Encouraging Industry Participation.
        © 2016 CAQH, All Rights Reserved.                     2
    The 2016 Provider Data Summit convened the industry to define provider data 
    challenges and responsive actions
       In September 2016, CAQH convened healthcare industry leaders in Washington, DC, to discuss pressing 
        provider data challenges in the era of cost control, healthcare reform, and pressure to innovate. 
       The Summit was informed by a white paper published by CAQH, Defining the Provider Data Dilemma, that 
        describes the challenges and environmental pressures on industry efforts to collect and maintain accurate 
        provider data.
         ­ Data about healthcare providers forms the foundation of many essential business processes across the healthcare 
             landscape, including directories, payment, referrals and credentialing. 
         ­ Poor quality data and inefficient data management approaches undermine those processes.
       The key recommendation of the participating stakeholders was the collective development of an industry 
        roadmap that would establish a long-term vision and outline a practical, collaborative, and cross-sector 
        approach to solving provider data issues. 
         © 2016 CAQH, All Rights Reserved.                            3
    The Summit outcomes included a call to develop an industry-wide roadmap of 
    actionable strategies for provider data
                                                                 Develop an Industry Roadmap
                                                                    Establish a long-term vision
                                                         Outline a practical, collaborative and cross-sector approach
                                                         Identify priority use cases and define the minimum data set 
                                                                         for each use case.
                                         Standardize                     Define and                  Centralize Data 
                                        Definitions and                 Maintain High-                 Resources
                                         Requirements                    Quality Data
                                                                                                 Streamline provider data 
                                      Create industry-accepted        Define quality measures 
                                      data definitions.                and benchmarks.             inputs and outputs.
                                                                                                 Sacrifice individual needs 
                                      Identify authoritative and      Create accountability 
                                      reliable data sources.           mechanisms.                 to meet the needs of 
                                                                                                   most.
                                     Foster regulatory               Identify and implement 
                                                                                                  Create data verification 
                                      alignment.                       incentives.
                                                                                                   processes.
                                                                  High-Quality Provider Data
                                                             Requires public and private sector collaboration.
                                                                Increases health access and outcomes.
                                                             Reduces costs and enables value based-care.
                                                                Improves consumer decision-making. 
          © 2016 CAQH, All Rights Reserved.                                 4
     The Provider Data Action Alliance was formed to define a shared industry vision and 
     develop the roadmap for provider data
        As recommended by a diverse group of stakeholders at the Provider Data Summit, the Provider Data 
         Action Alliance (Alliance) was formed in 2017 to:  
          ­ Convene public and private organizations to collaborate on provider data challenges.
                > The group met consistently over a six month period to develop the draft roadmap. 
                > They will support integration of industry feedback in Fall 2017.
          ­ Collectively develop a shared vision across the industry for provider data.
          ­ Design a roadmap of critical approaches and strategies that will reduce inefficiencies across the healthcare 
              system.
        The roadmap establishes a long-term vision and outlines a practical, collaborative, and cross-sector 
         approach to addressing provider data issues.
        The Alliance is seeking wider industry review of their draft roadmap. 
          © 2016 CAQH, All Rights Reserved.                                   5
     The Alliance participants represent* diverse segments of the healthcare ecosystem
                                                                        Participants
                           Providers                                                                                  Public Payers
             Hank Fanberg, CHRISTUS Health /                                                              Dennis Elliot, TennCare / Medicaid
               Health System                                                                               Richard Gilbert, CMS / Medicare
                                                                       Private Payers                   
             Michael Dowling, Montefiore / Health           Zig Brzezinski, Cigna / National              Dan Chaput, ONC / HHS - ONC
               System                                                                                      Katherine Knapp, VA / Military - VA
                                                              Health Plan
             Dave Lehr, Anne Arundel Hospital /             Jim Augustus, Humana / National 
               Single Hospital                                Health Plan
             Dave Marotz, SureScripts /                     Mike Avotins, Aetna / National 
               Pharmacy                                       Health Plan                                          HIEs / Marketplaces
                                                                                                           Robert Horst, CRISP / HIE
                                                             Ben Holiday, BCBST / Blue Health 
                                                                                                           Jeff Livesay, MiHIN / HIE
                                                              Plan                                         Lance Lang, Covered California / 
                          Regulators                         Jeffrey Schmitt, Harvard Pilgrim 
                                                              Health Plan / Provider Owned                  Public Marketplace
              Aaron Young, FSMB / Licensure
              Patricia Barrett, NCQA / Accreditor           Edward Sverdlin, United Dental / 
              Harnam Singh, NPDB / NPDB                      Dental
                                                             Bill Moore, Davis Vision / Vision
          *NOTE: Views of the participants are their own, and do not necessarily reflect those of their organizations. 
          © 2016 CAQH, All Rights Reserved.                                    6