Agenda Sneak Peek

Our team is working hard behind the scenes on the RISE National agenda. In the meantime, enjoy a sneak peek at some of the sessions you can expect when you join us on March 7-9, 2022 in Nashville.

Session Sneak Peek

Workshop

Spidey-Sense: Leveraging Interoperability Across the Payer-Provider Platform to Detect and React Faster and Better!

Connect your network “web” and address key pain points to keep your plan “out of danger”.

  • Weaving your Web – Electronic Chart Retrieval, EHR Integration, and Bi-Directional Connectivity
  • Harvesting your Catch – Pulling Data and Pushing Alerts electronically to close Risk and Quality Gaps more efficiently
  • Connecting your Webs – Building an interoperable Payer-Provider Platform to connect all players across the Care Continuum

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Risk Adjustment

Risk Adjustment Integrity: Best Practice Approaches for Balancing the Business Needs with Regulatory and Compliance Standards

  • Develop a multi-year strategy for improvement
  • Create and implementing a comprehensive strategy for evaluating the integrity and compliance aspects of your risk adjustment programs
  • Manage internal and vendor coding reviews
  • Improve coding accuracy and auditing with provider engagement
  • Evaluate your review process for clinical documentation, audit samples, coding and more

Elaine Taverna, Senior Vice President for Risk Adjustment and Quality
Advantasure

 

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Risk Adjustment

Rethinking People, Processes and Technology in Medicare Advantage for Core Administrative Services, Risk Adjustment, and Star Ratings

  • Compete in the land of the giants by attaining market leading core administration services and pricing
  • Create a model of service that allows you, the health plan and Risk bearing provider group, to focus on care delivery and member experience
  • Utilize the latest in Artificial Intelligence to enhance Risk Adjustment outcomes

 

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Risk Adjustment

Culturally Competent Health Care: The Power of Storytelling in Risk and Quality

  • Discuss the heightened importance of complete and accurate risk adjustment and quality data, inclusive of EDPS, as a foundation for SDoH and care gap closure
  • Learn tools and strategies for accessing and using complete and accurate data when implementing SDoH programs and risk and quality care gap closure activities, inclusive of plan benefit design
  • Hear how one heath plan uses innovative new tools to understand the story the data tells as a foundation for delivering culturally competent healthcare

Dawn Carter, Director, Product Strategy
Centauri Health Solutions

Eden Encarnacion, MHA, Director of Quality and Star Programs
Clever Care Health Plan

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Risk Adjustment

An Analytics-Driven Approach to Aligning Payer and Provider Incentives

  • Evaluate the maturity of payer-provider relationships to drive incentive program selection
  • Help providers, MSOs, and healthcare systems achieve success through analytic insights
  • Evolve payer-provider incentive programs to identify more mutually beneficial opportunities

 


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Risk Adjustment

Optimizing Risk Adjustment - Internal Operations, Vendor Strategy and Maintaining Control

  • Discuss chart retrieval, which records to chase and who should retrieve
  • Learn best practices for chart review – NLP, vendor alone or combined SaaS, and services
  • Maintain control throughout reporting, transparency, and provider education


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Member Experience

The Rx for Exceptional Customer Experience (CX)

  • Discuss customer expectations from a brand when interacting with them
  • Learn consumers needs and friction points across their journey with a brand
  • Hear how Covid-19 has modified consumers’ expectations
  • Gain strategies to help you impact future Medicare Advantage consumers (GenZ, Millennial, etc.)

Anne Stowell, Vice President Product Consumer Experience
Signify Health


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Member Experience

Revolutionizing Supplemental Benefits

  • Simplify member experience by streamlining benefit access
  • Flexibility to combine multiple benefits for your members all on one card: OTC products, healthy foods, fresh produce and meal delivery, dental, vision and hearing, transportation, incentives, and more
  • Members can shop in-store, online, over the phone, or via mail order. Over 65,000 retail locations in the OTC and healthy foods network

Dave Etling, Senior Vice President & General Manager
InComm


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Payer/Provider Collaboration

Retire Manual Retrieval: Embrace Automation to Streamline Chart Retrieval and Create a Closed Loop Retrieval and Coding Process

  • Adopt an enterprise retrieval platform for a better, faster, and cheaper way to access medical records while avoiding duplicate requests and reducing provider abrasion
  • Improve gap closure and revenue confidence through an integrated retrieval and coding process
  • Leverage NLP to unlock insights from your patient data that help with coding, suspecting, and population health initiatives

Shahyan Currimbhoy, Chief Product Officer 
Talix


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Payer/Provider Collaboration

Driving Risk Adjustment Accuracy with 360° Engagement

  • Use artificial intelligence to optimize engagement and reduce administrative burden
  • Partner with providers to integrate technology within their workflow
  • Leverage SDOH insights to optimize risk adjustment performance


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Payer/Provider Collaboration

RISE of the Payvider—AI-based Strategies for Successful Alliances

  • Hear how leading payvider organizations have tackled funding, financial incentives, and resource allocation to improve risk adjustment performance in both clinical risk capture and coding workflows
  • Discover the shared AI applications that drive payment accuracy and minimize compliance exposure via precise patient care and risk gap targeting
  • Learn about the different provider engagement, deployment approaches, and process takeaways from organizations three to five years into their payvider transformation


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Technology/Data Analytics

Risk Adjustment: Achieve Program Success by Measuring what Matters

  • Learn which measurements are the most effective for determining whether you’re on track to hit your goals
  • Discuss how to translate KPIs into impact for your risk adjustment program
  • Identify actions you can take to improve program performance


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Technology/Data Analytics

Navigating Interoperability & the Digital Frontier: The Healthcare Journey to Unleashing Real Value

  • Explore the new era of interoperability in healthcare, including the digital transformation underway to provide greater consumer access to healthcare data and the progress and challenges experienced thus far
  • Examine how upcoming Federal requirements will continue to transform the healthcare landscape in the years ahead
  • Learn about winning strategies for healthcare organizations leveraging data, analytics, and new technologies to inform patient targeting and enhance care coordination and delivery
  • Gain insight into how digital tools are driving greater consumer engagement and consumer-centric care, and thus, improved care outcomes


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Technology/Data Analytics

From Big Box to Out of the Box: Flexible Technology Trends for 2022

  • Demystify the multiple vendor vs. single platform partner approach
  • Learn where to focus your strategy and how to balance retro and prospective tactics
  • Discuss the biggest trends to expect from risk adjustment technologies that support a changing landscape


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Social Determinants of Health

Improve Health Outcomes and Address SDOH with Fresh Grocery Delivery

  • Discover innovative ways to improve member health with Food as Medicine
  • Improve members' diets and health outcomes, decreasecare costs, and address social determinants of health (SDOH) by providing access to healthy foods
  • Engaging members in an interactive wellness program designed by healthcare practitioners with a focus on using Food as Medicine, with special attention to food security

 

Ashley Tyrner, Founder and CEO
Farmbox Brands

Jennifer Spear, Associate Director of Population Health
Humana


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