ABBI+Payer+WG+Charter+Strawman+Vote

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Please review the Payer Charter and Straw Man below then vote and add comments
=Payer Workgroup - DRAFT WG Charter and Straw Man=

Synopsis
The aim of the ABBI Payer Content workgroup is to identify a practical human-readable and machine-readable content standard for Blue Button data, capable of conveying __both clinical and non-clinical health data__ offered by existing payers today, either by Blue Button or in EOB (Explanation of Benefits) documents today. **The goal is to arrive at a data & interoperability platform, feasible for payers & PBMs and attractive to developers to innovative apps & to create personally-controlled solutions that target clinical quality, affordability, access and the experience of care itself.**

In Scope
Note on Healthcare Financial Data: Is Financial data in-scope? (Yes.)
 * Leverage existing elements defined by public & private payers
 * Leverage existing standards if possible e.g. MyMedicare.gov ASCII, X12, HL7, cCDA extension, HealthVault EOB data model
 * Produce implementation guidance
 * Unlike “traditional” clinical health data...
 * Patient advocate organization represented in broader ABBI community meetings have expressed it as a priority.
 * Could be a “home run” for the ABBI Community if it enables more affordable care. (And if not us, who else will tackle this?)
 * Solutions themselves are out-of-scope; HOWEVER, the data standards & interoperability in-scope, and pre-requisite for 3rd-parties to create solutions.
 * How are patients getting it today?
 * Explanations of Benefit (EOBs) à concern about proprietary network discounting information, may need QH Policy-like stipulations!
 * Limited electronic access today (mostly PDF and/or “scraping” aggregators like Simplee & Cake Health)

Requirements
1. File content standard must allow for common data elements in payor & PBM-generated Blue Button ASCII files today, e.g. those generated by MyMedicare.gov Elements include: media type="custom" key="21243958"
 * Eligibility Dates
 * Provider Identifiers
 * Diagnosis Codes
 * Procedure Codes
 * Rx Codes
 * Financial Information related to transactions/encounters

media type="custom" key="21245024"

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