CORE: Join the Revolution

Full page advertisements are appearing in industry trade journals, headlining "Join the Revolution" featuring the logos of Aetna, Aultcare, BlueCross BlueShield of North Carolina, BlueCross BlueShield of Tennessee, HealthNet, Health Plan of Michigan, Humana and WellPoint.

The ads state: "Become part of the industry-wide revolution and nearly 100 other health plans, providers, clearinghouses and vendors that are committed to transforming the very way our industry communicates. Help advance health plan-provider interoperability while dramatically reducing administrative costs and improving provider relations. CORE. Let the revolution begin."

What is CORE? It stands for the Committee on Operating Rules for Information Exchange, and is governed by CAQH, the Council for Affordable Quality Healthcare, whose tag line now reads "simplifying healthcare administration." The CAQH web site can be found at http://www.caqh.com and the CORE portion of the site is provided as a featured link in this community. A three minute presentation providing an overview on CORE is available in the web site.

Here's the opening discussion on CORE's mission and vision from their web site:

"CAQH launched the Committee on Operating Rules for Information Exchange (CORE) in January 2005 with the vision of giving providers access to eligibility and benefits information before or at the time of service using the electronic system of their choice for any patient or health plan. CORE is more than 100 industry stakeholders – health plans, providers, vendors, CMS and other government agencies, associations, regional entities, standard-setting organizations and other healthcare entities. CORE participants maintain eligibility and benefits data for more than 130 million commercially insured lives plus Medicare and Medicaid beneficiaries. Working in collaboration they are building consensus on a set of operating rules that will:

1. Enhance interoperability between providers and payers
2. Streamline eligibility and benefits data transactions
3. Reduce the amount of time and resources providers spend on administrative functions – time better spent with patients"

The Site also includes background information on the CORE initiative, Operating Rules information, Governing Procedures, Steering Committee and Work Group information, Statements of Support, a list of Participating Organizations, Information on how to Join and more.

Anyone taking the journey towards healthcare simplification needs to make their next stop the CORE web site, and check it out. Applicable organizations wanting to inquire about participation in CORE can also contact Gwendolyn Lohse at: glohse@caqh.org or 202-861-1492.