1. HIT Policy Committee Accountable Care Workgroup – Kickoff Meeting April 19, 2013 3:30 – 4:30 PM Eastern

2. Agenda Welcome Introductions Process and Procedures for Federal Advisory Committee Workgroups Charter and Scope Review Initial Task Next Steps Public Comment 1

3. Accountable Care Workgroup (WG) Members WG Members Charles Kennedy, Aetna (Chair) Shaun Alfreds, HealthInfoNet Richard (Hal) Baker, Wellspan Karen Bell, CCHIT Karen Davis, Johns Hopkins Bloomberg School of Public Health John Fallon, BCBS Massachusetts Heather Jelonek, John C. Lincoln Accountable Care Organization David Kendrick, MyHealth Access Network Joe Kimura, Atrius Health Irene Koch, Brooklyn Health Information Exchange Aaron McKethan, RxAnte, Inc. Eun-Shim Nahm, University of Maryland School of Nursing Judy Rich, Tucson Medical Center Cary Sennett, IMPAQ International Bill Spooner, SHARP Healthcare Susan Stuard, THINC Grace Terrell, Cornerstone Health Care, P.A. Karen Van Wagner, North Texas Specialty Physicians Samuel VanNorman, Park Nicollet Health Services Ex Officio Members Akaki Lekiachvili, CDC Hongmai Pham, CMMI John Pilotte, CMS Westley Clark, SAMSHA 2

4. Process & Procedures for FACAs and Workgroups HIT Policy Committee gives advice to the National Coordinator for Health Information Technology, the recommendations are not binding. HIT Policy Committee is a Federal advisory Committee subject to the Federal Advisory Committee Act (FACA). Workgroups cannot provide advice or recommendations directly to ONC, they only report to the parent Committee All Workgroup meetings are open to the public, and the public may make comments at the close of the meeting Majority of the Workgroup calls are held virtually with possible in person meetings, listening sessions or hearings Detailed minutes are kept for each meeting and are posted on the ONC website along with all meeting materials All official calendar appointments and meeting materials are distributed from the ONC FACA Meetings email account 3

5. HIT Policy Committee & Workgroups Health Information Technology Policy Committee Chair- Farzad Mostashari Vice Chair- Paul Tang Accountable Care Workgroup Chair- Charles Kennedy Consumer Empowerment Workgroup Chair- Christine Bechtel Certification and Adoption Workgroup Co-Chairs- Larry Wolf and Marc Probst Governance Workgroup Chair- John Lumpkin Information Exchange Workgroup Chair – Micky Tripathi Meaningful Use Workgroup Chair- Paul Tang Co-Chair- George Hripcsack Privacy and Security Tiger Team Chair- Deven McGraw Co-Chair- Paul Egerman Quality Measures Workgroup Chair- Helen Burstin Co-Chair- Theresa Cullen 4

6. HIT Standards Committee & Workgroups Health Information Technology Standards Committee Chair- Jonathan Perlin Vice Chair- John Halamka Consumer Technology Workgroup Chair- Leslie Kelly Hall Clinical Operations Workgroup Chair- James Ferguson Co-Chair- John Halamka Clinical Quality Workgroup Chair- James Walker Co-Chair- Marjorie Rallins Implementation Workgroup Co-Chairs- Christopher Ross & Elizabeth Johnson Nationwide Health Information Network Power Team Chair- Dixie Baker Privacy and Security Workgroup Chair- Dixie Baker Co-Chair- Walter Suarez 5

7. Charge & Scope from WG Charter Charge: Make recommendations to the Health IT Policy Committee on how HHS policies and programs can advance the evolution of a health IT infrastructure that enables providers to improve care and population health while reducing costs in accountable care models. Scope of work: Likely areas of focus include: – Supporting the evolution of data aggregation and analytics capabilities that are scalable and accessible across disparate providers for ACO success. – Enabling and encouraging information exchange to support care coordination across providers, including non-core care and wellness providers that have a significant impact on readmissions rates and total cost of care for a patient, including long-term care facilities, home health providers, long term support services providers and other community-based organizations. – Increasing patient activation as a member of a defined care team, engaging patients in assessments of their health, and using technology to deliver care to patients outside of traditional care settings. – Aligning payment policy & health information exchange for sustainable ACO success. – Improving the linkage between functionality and value creation. 6

8. Charge & Scope from WG Charter Scope (con’t): Examples of policy issues the WG may engage in include: – Uptake of Meaningful Use and certification of electronic health record systems (EHRs), for instance, recommending inclusion of quality measures critical to ACOs and considering certification of health IT components for ACOs; – Standards and interoperability activities, for instance, providing input on work around developing standards for exchanging data with long term care facilities and incorporating data from remote monitoring devices used to manage chronic disease and prevent avoidable readmissions; – Medicare Shared Saving and other payment pilot guidance; and – Coordination opportunities across federal partners such as ONC, CMS, AHRQ, HRSA, and NLM, for instance, reconciling measure requirements between ACO and MU programs. Important touch points with other workgroups: 7 – HITPC Meaningful Use WG – HITPC Privacy & Security Tiger Team WG – HITPC Quality Measures WG – HITSC Consumer Technology WG – HITPC Data Intermediaries Tiger Team – HITPC Information Exchange WG

9. Initial Task Recommend a set of next steps for HHS to further drive the evolution of an HIT infrastructure to support models of accountable care, considering the following strategies: – Voluntary health IT certification program focused on accountable care – Guidance around development of measures more specific to accountable care models, e.g., patient centered, longitudinal e-measures Recommendations should also consider regulatory issues around: – Alignment with forthcoming Meaningful Use Stage 3 requirements with needs of accountable care models – Alignment with forthcoming CMS/CMMI program requirements 8

10. Environmental Scan Accountable Care Models: Current Landscape – Federal Program Participants: Pioneer/Advanced Payment/MSSP/CPCI – ACOs with Commercial Health Plan Contracts Program Requirements – Design of key CMS/CMMI payment programs – Overview of measurement requirements Literature Review on HIT Components to Support Accountable Care – Compilation of key journal articles/grey literature/etc. highlighting critical components and capabilities for accountable care – Forthcoming CCHIT Framework Regulatory Context – Overview of Meaningful Use Stage 3 RFC highlighting proposed requirements most relevant to accountable care – Overview of regulatory framework for CMS/CMMI programs 9

11. Next Steps Finalize initial task and workplan Suggest briefings for future calls/information gathering activities 10