Schedule

RISE National 2022 features 25 hours of programming, 35+ timely sessions, and 150+ expert speakers, with an agenda designed for the functional thinker to leave equipped and re-energized to push your organization forward in the evolving Medicare Advantage landscape. Take a look at what we have planned for you in Nashville on March 7-9, 2022 and use the "filter" functionality to see the agenda sessions that mean the most to you and your job function.

Monday - March 7, 2022

10:00 AM 4:00 PM

9:00 AM 3:00 PM

8:00 AM 2:00 PM

7:00 AM 1:00 PM

Workshop A: Risk Adjustment Practitioner

  • The essentials of and differences between Medicare Advantage, Commercial and Medicaid risk adjustment  
  • Understanding how risk scores are calculated  
  • Making sense of varying payment models  
  • An intro into using data and predictive analytics to optimize your risk adjustment practices  
  • Tools for achieving data accuracy  
  • Where do we stand with the transition from RAPS to EDS? The latest in a long journey  
  • Provider engagement strategies that will impact your risk adjustment initiatives  
  • Risk adjustment vendor selection and management  
  • Determining whether you need RA vendors  
  • How do you effectively vet potential vendors and ultimately select them?  
  • Strategies for on-going, thorough vendor management  
  • The future of risk adjustment – what you need to know to stay ahead of possible changes  
  • Initial steps for preparing for a RADV audit  
  • Which staff is essential to overseeing your RADV audit prep?  
  • Staying ahead – key items to monitor well in advance of an actual audit  

Instructors:  
Laura Sheriff, RN, MSN, CPC, CRC 

Susan Waterman, RHIT, CCS, CPC, CRC, AHIMA ICD-10-CM/PCS, Trainer, Director, Risk Adjustment 
Scott & White Health Plan

10:00 AM 4:00 PM

9:00 AM 3:00 PM

8:00 AM 2:00 PM

7:00 AM 1:00 PM

Workshop B: Advanced HCC Auditor

The HCC Coding for Accuracy workshop is not just for those directly involved in HCC coding work. It is designed for other disciplines, as well, including finance and analytics professionals. Join us for an introduction to best practices, the opportunity to work through case examples, and to share experiences with your peers. This workshop will zero-in on regulatory compliance while teaching you how to optimize the accuracy of the information gathered and submitted at the practice level. What you will also learn about the way charting is often done, how to overcome “disconnect” with the clinicians and how their typical charting practices and EMRs can create significant problems, and how RADV views documentation in contrast with the way clinicians were taught and EMRs were built initially.  

Please note: Attendees are encouraged to bring questions to pose to our expert workshop facilitators and to the table for the group. We provide your workbook which includes copies of the slide deck. You will not need your coding manuals, but most people take notes on their laptop or tablet. 

 

Dialogue, interact and work in small, facilitated groups with peers and colleagues   

  • Understanding the financial overlay – HCC codes mapping to risk adjustment scores   
  • A single coding and documentation process for  
  • Risk adjustment   
  • Skill development on choosing diagnoses from portions of the encounter – permitted and not permitted   
  • Clinical documentation barriers for risk adjustment purposes (data validation audit risks)   

Instructors:
Colleen Gianatasio, Director of Ambulatory CDQI
Mount Sinai Health Partners

Donna Malone, CPC, CRC, AAPC Approved Instructor, AHCCA, RAP
Director Clinical Documentation and Quality Improvement (CDQI),
Mount Sinai Hospital System

2:00 PM 5:00 PM

1:00 PM 4:00 PM

12:00 PM 3:00 PM

11:00 AM 2:00 PM

Workshop C: 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 

Megan Zakrewsky, Director of Product, Clinical Data Exchange
Pulse8

Meghan West, Sr. Solutions Manager, Collabor8
Pulse8

Scott Stratton, Chief Data Scientist, Business Development
Pulse8

1:00 PM 5:00 PM

12:00 PM 4:00 PM

11:00 AM 3:00 PM

10:00 AM 2:00 PM

Workshop D: Risk Adjustment Management Strategies and Updates

This four-hour workshop is designed for those new to leadership for risk adjustment, or for existing RA leaders who are looking for a conversation on the latest trends and issues around RA operations, compliance, coding, and vendor management. 

You will discuss: 

  • How emerging regulatory and ongoing litigation should impact your operations 
  • The latest coding changes and how to ensure you stay current for your organization and/or venders – even if you are not a coder! 
  • Best practice for vendor oversight and internal resource allocation 
  • Compliance must haves and how to build programs that meet your business and oversight needs in an integrated way 

Speakers: 
David Meyer, Member 
RISE Policy Committee  

 

5:00 PM 6:00 PM

4:00 PM 5:00 PM

3:00 PM 4:00 PM

2:00 PM 3:00 PM

Welcome Cocktail Reception – All Conference Attendees Invited

Let's kick off the mega Medicare Advantage event of the year! All attendees are invited to join us in the exhibit hall for drinks, hors d'oeuvres, and face-to-face networking. We will have a color-coded system in place to allow attendees to self-select and display their comfort level for interacting with peers. 

Tuesday - March 8, 2022

8:30 AM 9:30 AM

7:30 AM 8:30 AM

6:30 AM 7:30 AM

5:30 AM 6:30 AM

Networking Breakfast in Exhibit Hall

8:30 AM 8:30 PM

7:30 AM 7:30 PM

6:30 AM 6:30 PM

5:30 AM 5:30 PM

Exhibit Hall Opens

9:45 AM 10:00 AM

8:45 AM 9:00 AM

7:45 AM 8:00 AM

6:45 AM 7:00 AM

Opening Remarks

Ellen Wofford, Managing Director
RISE

Conference Chairs:
RaeAnn Grossman, EVP, Operations - Risk Adjustment, Population Health Management, and Quality
Cotiviti, Inc.

Kevin M. Healy, CEO
Allymar Health Solutions

10:00 AM 10:45 AM

9:00 AM 9:45 AM

8:00 AM 8:45 AM

7:00 AM 7:45 AM

Centers for Medicare & Medicaid Services (CMS)

Invited

10:45 AM 11:30 AM

9:45 AM 10:30 AM

8:45 AM 9:30 AM

7:45 AM 8:30 AM

Office of the Inspector General (OIG)

Invited

11:30 AM 11:40 AM

10:30 AM 10:40 AM

9:30 AM 9:40 AM

8:30 AM 8:40 AM

Networking Break in Exhibit Hall

11:40 AM 12:35 PM

10:40 AM 11:35 AM

9:40 AM 10:35 AM

8:40 AM 9:35 AM

RISE Policy Committee: 2022 Regulatory Year in Review

Join the RISE Policy Committee members and experts as they breakdown the 2022 most impactful regulatory changes and expectations placed on health plans around the country. They will discuss the first notice under the new administration,  and what to expect in the regulatory landscape.  

Sean Creighton, Member
RISE Policy Committee

Michael S. Adelberg, Principal
Faegre Drinker Consulting 

David Meyer, Member
RISE Policy Committee

Concurrent Sessions 12:35 PM - 1:20 PM 11:35 AM - 12:20 PM 10:35 AM - 11:20 AM 9:35 AM - 10:20 AM

12:35 PM 1:20 PM

11:35 AM 12:20 PM

10:35 AM 11:20 AM

9:35 AM 10:20 AM

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

Risk Adjustment Strategies
  • Develop a multi-year strategy for improvement 
  • Create and implement 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 

 

12:35 PM 1:20 PM

11:35 AM 12:20 PM

10:35 AM 11:20 AM

9:35 AM 10:20 AM

The Rx for Exceptional Customer Experience (CX)

Member Journey and Experience
  • 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

12:35 PM 1:20 PM

11:35 AM 12:20 PM

10:35 AM 11:20 AM

9:35 AM 10:20 AM

Unifying NLP-enabled Risk Adjustment Processes for Improved Revenue Integrity and Gap Closure

Payer/Provider Collaboration
  • Integrate the traditionally siloed processes of suspecting, retrieval, coding, and submissions to increase revenue confidence and oversight 
  • Create a unified, NLP-enabled retrieval and coding platform to increase efficiency and improve gap closure 
  • Enhance payer-provider collaboration through prospective gap closure and electronic data exchange 
  • Unlock actionable insights from charts with NLP to support population health and value-based programs 

Katy Davis, MBA, CPC, CPMA, Director, Risk Adjustment Coding Quality and Compliance 
Medical Mutual of Ohio 

Shahyan Currimbhoy, Chief Product Officer  
Talix  

 

12:35 PM 1:20 PM

11:35 AM 12:20 PM

10:35 AM 11:20 AM

9:35 AM 10:20 AM

HEDIS, Stars and Risk Adjustment: A Town Hall Event with Senior Quest Clinical Leadership and TBD Health Plan Leadership

Quality, HEDIS® and Stars
  • What we've learned so far about the past 2 years of the COVID pandemic and how it has affected your member’s choices on health care:  the data but most importantly; how use that data to leverage better health outcomes 
  • Building and rebuilding "trust" with your members: each community is different and each communities has specific needs   
  • Medical services with empathy: how to give your members safe options on access to their health care  
  • Only constant in health care is change: clinical view of what to expect from the pandemic and how health care will look for the rest of 2022, 2023, and beyond  

Dr. Shannon Decker, M.Ed., MBA, PhD., Vice President, Clinical Performance
Brown & Toland

Jay Wohlgemuth MD, CMO & Physician Executive
Quest Diagnostics

Steve Goldberg, MD, MBA, VP, Chief Health Officer, Medical Affairs & Diagnostic Services
Quest Diagnostics

12:35 PM 1:20 PM

11:35 AM 12:20 PM

10:35 AM 11:20 AM

9:35 AM 10:20 AM

Realizing The Return: Ensuring Service Providers Deliver Value

Technology/Data Analytics
  • Discussion of the components of a strong vendor management program, including financial accountability 
  • Helping clients understand the value proposition of your platform and the strategies employed to increase value 
  • How to create a process to measure return, including translating platform usage statistics to value 

Wayne Gibson, Senior Managing Director, Health Solutions
FTI Consulting

1:20 PM 2:10 PM

12:20 PM 1:10 PM

11:20 AM 12:10 PM

10:20 AM 11:10 AM

Networking Lunch in Exhibit Hall

Concurrent Sessions 2:15 PM - 3:00 PM 1:15 PM - 2:00 PM 12:15 PM - 1:00 PM 11:15 AM - 12:00 PM

2:15 PM 3:00 PM

1:15 PM 2:00 PM

12:15 PM 1:00 PM

11:15 AM 12:00 PM

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

Risk Adjustment Strategies
  • 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 

Lisa Slattery, Chief Strategy and Compliance Officer 
Allymar Health Solution 

Lesley Weir, Chief Risk Adjustment and Quality Officer
ATRIO Health Plans 

2:15 PM 3:00 PM

1:15 PM 2:00 PM

12:15 PM 1:00 PM

11:15 AM 12:00 PM

Revolutionizing Supplemental Benefits

Member Journey and Experience
  • 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

 

2:15 PM 3:00 PM

1:15 PM 2:00 PM

12:15 PM 1:00 PM

11:15 AM 12:00 PM

Driving Risk Adjustment Accuracy with 360° Engagement

Payer/Provider Collaboration
  • 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 

Aria Sameni, Vice President of Growth and Strategy 
Optum

James Hereford, Chief Executive Officer 
M Health Fairview

 

2:15 PM 3:00 PM

1:15 PM 2:00 PM

12:15 PM 1:00 PM

11:15 AM 12:00 PM

Risk Adjustment: Achieve Program Success by Measuring what Matters

Technology/Data Analytics
  • 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 

 

Eric Hedrick, Vice President, Analytics 
Advantmed 

Donna Page, Senior Director, Risk Adjustment Operations 
Cigna 

 

2:15 PM 3:00 PM

1:15 PM 2:00 PM

12:15 PM 1:00 PM

11:15 AM 12:00 PM

Session to be announced

Quality, HEDIS® and Stars

3:00 PM 3:20 PM

2:00 PM 2:20 PM

1:00 PM 1:20 PM

12:00 PM 12:20 PM

Networking Break in Exhibit Hall

Concurrent Sessions 3:20 PM - 4:05 PM 2:20 PM - 3:05 PM 1:20 PM - 2:05 PM 12:20 PM - 1:05 PM

3:20 PM 4:05 PM

2:20 PM 3:05 PM

1:20 PM 2:05 PM

12:20 PM 1:05 PM

Reimagining Risk Adjustment: Member Data Collection for the Digital Age

Risk Adjustment Strategies
  • Ensure the right input for government reimbursements, support healthier members, and improve workflow for employees while reducing costs and provider abrasion 
  • Learn how to employ data and technology to augment your risk adjustment by leveraging digital accessibility, pre-identified optimal member sets, and social determinants of health 
  • Understand how the old ways and modern methods still must work together to deliver a comprehensive fulfillment yield, improve departmental efficiency, and scale to meet the plan’s needs 
  • Utilize full-spectrum encounter and coding data to maximize member engagement and quality of care 

Session by Ciox 

3:20 PM 4:05 PM

2:20 PM 3:05 PM

1:20 PM 2:05 PM

12:20 PM 1:05 PM

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

Payer/Provider Collaboration
  • 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 

Rebecca Welling, AVP, Risk Adjustment and Coding
SelectHealth

Jessica Columbus, AVP STARs & Risk Adjustment
Apex Health Solutions

3:20 PM 4:05 PM

2:20 PM 3:05 PM

1:20 PM 2:05 PM

12:20 PM 1:05 PM

National Committee for Quality Assurance (NCQA) 2022 Update

Quality, HEDIS® and Stars

Join this key update focused on the move to digital measures, new measures for 2022 and expectations for health plans, why HEDIS measures are still important during and post COVID, and a discussion involving SDoH, health equity, and the new Health Equity Accreditation program. Mr. Micciche will also discuss behavioral health challenges and related measures. 

Moderator:
Ana Handshuh, Principal
CAT5 Strategies

Frank Micciche, Vice President, Public Policy and External Relations  
National Committee for Quality Assurance (NCQA) 

 

3:20 PM 4:05 PM

2:20 PM 3:05 PM

1:20 PM 2:05 PM

12:20 PM 1:05 PM

Make Each Moment Count – Strategies for achieving member-centric delivery of integrated quality and risk score accuracy excellence

Technology/Data Analytics
  • Assess how care delivery is being provided today across the US healthcare landscape and the challenges towards achieving value-based care outcomes 
  • Outline the merits and pitfalls of best practices in integrating quality improvement and risk score accuracy documentation and member engagement activity 
  • Gain insight into different approaches to integrating programs that reflect the true disease burden of populations 
  • Understand the value and challenges of an integrated program and the important role that compliance with changing and complex regulatory guidelines plays 

Moderator:
Kristopher Volrath, Vice President, Field Products and Solutions
Inovalon

Speakers:
John Linnehan, Practice Director, Health Economics & Advanced Analytics
Avalere Health

Dr. Paige Kilian, Chief Medical Officer
Inovalon

3:20 PM 4:05 PM

2:20 PM 3:05 PM

1:20 PM 2:05 PM

12:20 PM 1:05 PM

Engaging the Member and Their Informal Caregivers to Support Risk Adjustment Data Collection and Risk Score Accuracy

Member Journey and Experience

Session by Cortex Analytics

Concurrent Sessions 4:10 PM - 4:55 PM 3:10 PM - 3:55 PM 2:10 PM - 2:55 PM 1:10 PM - 1:55 PM

4:10 PM 4:55 PM

3:10 PM 3:55 PM

2:10 PM 2:55 PM

1:10 PM 1:55 PM

Session to be announced

Risk Adjustment Strategies

Session by Apixio

4:10 PM 4:55 PM

3:10 PM 3:55 PM

2:10 PM 2:55 PM

1:10 PM 1:55 PM

Two Birds, One Stone: Risk Adjustment Accuracy with Payment Integrity

Compliance and Regulatory Updates
  • Optimize your program for the latest CMS, OIG, and DOJ investigation trends  
  • How to have high accuracy above and below the compliance line 
  • Win the payment integrity battle while reducing audit risk 
  • Finance performance and coding accuracy are friends 

Ana Handshuh, Principal
CAT5 Strategies

George Witwer, CEO
Cavo Health

4:10 PM 4:55 PM

3:10 PM 3:55 PM

2:10 PM 2:55 PM

1:10 PM 1:55 PM

Elevating Risk Adjustment by Activating Physician Participation

Payer/Provider Collaboration
  • Learn how to create better collaboration and alignment between health plans and providers to significantly improve financial and clinical performance 
  • Understand why it is critical to engage PCPs in risk adjustment and quality of care initiatives to achieve success in VBC arrangements 
  • Discover why you do not need to sacrifice yield to reduce compliance risk by implementing a PCP-centric risk adjustment program  

Josh Stern, Chief Revenue Officer 
Vatica Health

 

4:10 PM 4:55 PM

3:10 PM 3:55 PM

2:10 PM 2:55 PM

1:10 PM 1:55 PM

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

Risk Adjustment Strategies
  • 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 

Session by GeBBS 

4:10 PM 4:55 PM

3:10 PM 3:55 PM

2:10 PM 2:55 PM

1:10 PM 1:55 PM

The Risk Adjustment “Platform”: Advanced Technologies to Improve Patient Outcomes & Plan Performance

Technology/Data Analytics
  • Streamlining workflows with an end-to-end platform to reduce provider abrasion, ensure accurate risk scores and improve patient care. 
  • How greater data transparency helped one health plan unlock $1M in potential lost revenue 
  • Using tech for better data insights to prioritize the most impactful interventions 
  • Utilizing advanced analytics for higher campaign volume and more targeted prospective strategies 
  • How reimbursements ultimately impact patient outcomes 

Session by Episource 

5:00 PM 5:50 PM

4:00 PM 4:50 PM

3:00 PM 3:50 PM

2:00 PM 2:50 PM

Go From A to THE®: Stop Being A Leader. Start Being THE Leader

Today’s world is competitive, innovative, and seriously fast-paced. When we are serious about growing our business, it is no longer acceptable to offer A product, A solution or even be A Leader. Today’s consumers, employees and followers want THE product, THE solution and THE leader to follow. When we want to eliminate our competition, set record sales, motivate others to action and produce solutions that actually matter, it’s time to go from A to THE 

Ryan Avery 
Emmy-award winning journalist, two-time bestselling author and world record holder

5:50 PM 6:50 PM

4:50 PM 5:50 PM

3:50 PM 4:50 PM

2:50 PM 3:50 PM

Interactive Roundtables Part One

Select from Different Presentations Spotlighting Health Care’s Most Influential Technology and Solution Gurus Presenting Tools to Elevate Your Plan’s Initiatives.  

Pull up a chair and settle in for this unique opportunity to select three interactive, speed-networking type presentations featuring the latest technologies and solutions for boosting your plan’s risk, quality and data management endeavours. A bell will ring three times within this special 60-minute session, alerting you to transition to the next roundtable of your choice. 

6:50 PM 8:30 PM

5:50 PM 7:30 PM

4:50 PM 6:30 PM

3:50 PM 5:30 PM

Networking Cocktail Reception in Exhibit Hall

Grab a cocktail and small bite, and get back to that face-to-face networking we’ve all been missing. During this extended networking reception, enjoy comfortable networking with our color-coded system in place allowing attendees to self-select and display their comfort level for interacting with peers. 

Wednesday - March 9, 2022

8:30 AM 10:00 AM

7:30 AM 9:00 AM

6:30 AM 8:00 AM

5:30 AM 7:00 AM

Networking Breakfast in Exhibit Hall

8:30 AM 4:35 PM

7:30 AM 3:35 PM

6:30 AM 2:35 PM

5:30 AM 1:35 PM

Exhibit Hall Open

9:00 AM 10:00 AM

8:00 AM 9:00 AM

7:00 AM 8:00 AM

6:00 AM 7:00 AM

Interactive Roundtables Part Two

Select from Different Presentations Spotlighting Health Care’s Most Influential Technology and Solution Gurus Presenting Tools to Elevate Your Plan’s Initiatives.  

Pull up a chair and settle in for this unique opportunity to select three interactive, speed-networking type presentations featuring the latest technologies and solutions for boosting your plan’s risk, quality and data management endeavours. A bell will ring three times within this special 60-minute session, alerting you to transition to the next roundtable of your choice. 

10:00 AM 10:05 AM

9:00 AM 9:05 AM

8:00 AM 8:05 AM

7:00 AM 7:05 AM

Day Two Welcome Remarks and Day One Takeaways

Conference Chairs:

RaeAnn Grossman, EVP, Operations - Risk Adjustment, Population Health Management, and Quality
Cotiviti, Inc.

Kevin M. Healy, CEO
Allymar Health Solutions

10:05 AM 10:25 AM

9:05 AM 9:25 AM

8:05 AM 8:25 AM

7:05 AM 7:25 AM

The Dr. Martin L. Block Award Presentation

In the spirit of the RISE mission to encourage continuous improvement in the health care system, The Dr. Martin L. Block Award for Innovation & Excellence is presented to an esteemed nominee each year at RISE National. This prestigious accolade acknowledges an individual’s effort to enhance the lives of America’s seniors through clinical leadership, policy vision and by superior example. Nominate a colleague today at risehealth.org/MLblock. 

10:25 AM 11:25 AM

9:25 AM 10:25 AM

8:25 AM 9:25 AM

7:25 AM 8:25 AM

What We’ve Learned about the Pandemic

Dr. Messonnier has first-hand insight from the most important chapter in the history of US public health. She led efforts including distribution, administration, education and partner engagement, safety and effectiveness evaluation and access for hard-to-reach populations with the goal of ensuring that a safe and effective COVID-19 vaccine would be available to every American who wanted one.  She is now Executive Director for Pandemic Prevention and Health Systems at the Skoll Foundation.  She will discuss the current healthcare landscape, immunization hesitancy, and the future of public health. 

Dr. Nancy Messonnier, Former Director of the Centers for Disease Control 
National Center for Immunization and Respiratory Diseases 
Executive Director for Pandemic Prevention and Health Systems 
Skoll Foundation 

 

11:25 AM 11:45 AM

10:25 AM 10:45 AM

9:25 AM 9:45 AM

8:25 AM 8:45 AM

Networking Break in Exhibit Hall

11:45 AM 12:40 PM

10:45 AM 11:40 AM

9:45 AM 10:40 AM

8:45 AM 9:40 AM

Keynote Address: To be announced

Concurrent Sessions 12:45 PM - 1:30 PM 11:45 AM - 12:30 PM 10:45 AM - 11:30 AM 9:45 AM - 10:30 AM

12:45 PM 1:30 PM

11:45 AM 12:30 PM

10:45 AM 11:30 AM

9:45 AM 10:30 AM

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

Risk Adjustment Strategies
  • 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

12:45 PM 1:30 PM

11:45 AM 12:30 PM

10:45 AM 11:30 AM

9:45 AM 10:30 AM

Improve Health Outcomes and Address SDoH with Fresh Grocery Delivery

Social Determinants of Health
  • Discover innovative ways to improve member health with Food as Medicine 
  • Improve members' diets and health outcomes, decrease care costs, and address social determinants of health (SDoH) by providing access to healthy foods 
  • Engaging members in an interactive wellness program designed by health care 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

12:45 PM 1:30 PM

11:45 AM 12:30 PM

10:45 AM 11:30 AM

9:45 AM 10:30 AM

The Value of Provider Quality in Digital Front Door Tools

Digital Health Care Delivery
  • Examine how innovative health plans are leveraging new solutions to remain competitive, especially in exchange and individual markets 
  • Unpack elements of provider quality like safety, efficiency, efficacy, and price as well as reveal new data insights on how virtual provider networks stack up in terms of quality 
  • Discuss value-based strategies that health plans have used to ensure that virtual primary care is high-quality and clinically effective while still lowering costs 

Dr. Ian Tong, Chief Medical Officer
Included Health

Beth-Ann Roberts, President, Commercial Business
Point32Health

12:45 PM 1:30 PM

11:45 AM 12:30 PM

10:45 AM 11:30 AM

9:45 AM 10:30 AM

Real Life RA Compliance Failures:  How to Avoid Turning a “Glitch” Into a “Gotcha”?

Compliance and Regulatory Updates
  • Understand the current state of the law in the RA context of how courts draw the line between what the U.S. Supreme Court has characterized as “garden-variety breaches of contract or regulatory violations,” which are not actionable under the FCA, and compliance failures that constitute actual fraud 
  • Learn how RA compliance problems, if not addressed quickly and appropriately, can escalate into much bigger litigation headaches for an organization 
  • Hear about real-life best practices for responding to internal whistleblower complaints, and how the active use of internal hotlines can add value and profitability to an organization 

Edward A. Baker, Of Counsel
Constantine Cannon LLP

12:45 PM 1:30 PM

11:45 AM 12:30 PM

10:45 AM 11:30 AM

9:45 AM 10:30 AM

Innovating with AI to Proactively Close the Gaps in Outpatient Care

Future of Healthcare
  • Harness AI to identify patient risk and intervention opportunities 
  • Proactively evaluate patient data to identify evidence of chronic/risk-adjusted conditions  
  • Build a personalized patient approach to wellness and chronic disease management 

Mike S. Jones, Vice President & General Manager, Clinical Quality and Revenue Integrity 
Nuance Communications  

 

1:30 PM 2:30 PM

12:30 PM 1:30 PM

11:30 AM 12:30 PM

10:30 AM 11:30 AM

Networking Break in Exhibit Hall

Concurrent Sessions 2:30 PM - 3:15 PM 1:30 PM - 2:15 PM 12:30 PM - 1:15 PM 11:30 AM - 12:15 PM

2:30 PM 3:15 PM

1:30 PM 2:15 PM

12:30 PM 1:15 PM

11:30 AM 12:15 PM

An Analytics-Driven Approach to Aligning Payer and Provider Incentives

Risk Adjustment Strategies
  • 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 

Jonas Foit, Senior Vice President, RQNC Analytics & Reporting
Cotiviti, Inc.

2:30 PM 3:15 PM

1:30 PM 2:15 PM

12:30 PM 1:15 PM

11:30 AM 12:15 PM

Session presented by Change Healthcare

Social Determinants of Health

2:30 PM 3:15 PM

1:30 PM 2:15 PM

12:30 PM 1:15 PM

11:30 AM 12:15 PM

What Would Failure Look Like for the ACA’s Risk Adjustment Program?

Compliance and Regulatory Updates
  • Impact of reconciliation (or the absence of reconciliation) on the ACA landscape, enrollment, and risks 
  • Recap beyond compliance for the commercial market– risk adjustment challenges for 2022 

J. Gabriel McGlamery, J.D., Senior Health Care Policy Consultant 
Florida Blue Center for Health Policy 

2:30 PM 3:15 PM

1:30 PM 2:15 PM

12:30 PM 1:15 PM

11:30 AM 12:15 PM

The Authenticity Advantage: Your New Secret Weapon for Success

Special Presentation: Women in Heath Care Leadership

You've probably heard "Bring your authentic self to work" a hundred times in the last year [insert eye roll]. But here's the reality: being "yourself" at work probably feels like a fluffy unicorn that isn't really possible. 

During this talk, Erin will help you see that authenticity is a much more nuanced and complex concept. And, when embraced in this way, it turns authenticity from a passive, la-ti-da concept to your active, dy-no-mite advantage that will ensure you get the success you deserve, without compromising everything else.  

Grounded in her proprietary framework, The Six Principles of Strategic Authenticity (H.U.M.A.N.S.), she’ll provide some initial “plays” that will help you put your authenticity in motion as soon as you leave the session. Delivered of course with full-on authenticity, this talk will inspire you to break the crusty workplace "rules" to breakthrough to big success! 

Erin Hatzikostas, Founder
b Authentic
Former Corporate Health Care Financial Institution CEO turned Professional Pot-Stirrer
Author of You Do You(ish) and TEDx Speaker

2:30 PM 3:15 PM

1:30 PM 2:15 PM

12:30 PM 1:15 PM

11:30 AM 12:15 PM

Rehumanize Care Through Communication and Relationship Skills

Furture of Healthcare

The COVID-19 pandemic thrust health care into a virtual mode of delivery. Technology solutions, such as electronic health records and telehealth utilization, are often criticized in connection to dehumanization of care delivery and to provider burnout.  

Intersections between technology, human communication, and relationships pose both opportunities and threats to the quality of health care experiences. 

This session will emphasize opportunities to leverage digital health care tools, while maintaining a strong human connection through skills to strengthen communication and relationships. 

Participants will engage in brief interactive activities to demonstrate simple communication skill-building techniques.   

You will:  

  1. Recognize opportunities to leverage digital health care tools to improve patient and clinician experiences. 
  2. Explore communication skills to strengthen connections during in-person or virtual health care encounters. 

Laura Cooley, PhD, Senior Director of Education and Outreach 
Academy of Communication in Healthcare 
Editor-in-Chief 
The Journal of Patient Experience 

 

3:15 PM 3:55 PM

2:15 PM 2:55 PM

1:15 PM 1:55 PM

12:15 PM 12:55 PM

Bringing It All Together – Closing Roundtable and Key Takeaways

The track chairs from today’s session will come together one last time to discuss this year’s main themes, expectations for a post-COVID health care landscape, and send you back to your organizations armed with a plan to implement the key takeaways from this year’s conference 

3:55 PM 4:00 PM

2:55 PM 3:00 PM

1:55 PM 2:00 PM

12:55 PM 1:00 PM

Closing Remarks

RaeAnn Grossman, EVP, Operations - Risk Adjustment, Population Health Management, and Quality 
Cotiviti, Inc. 

Kevin M. Healy, CEO 
Allymar Health Solutions