2022 Schedule

RISE National 2022 featured 25 hours of programming, 40+ timely sessions, and 90+ 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 attendees experienced at our 2022 event and make plans to join us in 2023!

Monday - March 7, 2022

9:00 AM 10:00 AM

8:00 AM 9:00 AM

7:00 AM 8:00 AM

6:00 AM 7:00 AM

Workshop Registration

10:00 AM 5:00 PM

9:00 AM 4:00 PM

8:00 AM 3:00 PM

7:00 AM 2:00 PM

Main Conference Registration

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
Risk Adjustment Specialist

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

 

Scott Weiner, Director, Government Programs
Sentara  

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
Veradigm

Meghan West, Sr. Solutions Manager, Collabor8
Pulse8

Scott Stratton, Chief Data Scientist, Business Development
Pulse8

Sharon Kuhrt, Director, Medicare Stars
Priority Health

Mike Baker, Director, Enterprise Risk Adjustment
EmblemHealth

Dean Ratzlaff, Actuary
Optima Health

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  

Laura Sheriff, RN, MSN, CPC, CRC
Risk Adjustment Specialist

Sean Creighton, Member
RISE Policy Committee

Jason Eric Christ, JD, Attorney
Epstein Becker Green

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 7:00 PM

7:30 AM 6:00 PM

6:30 AM 5:00 PM

5:30 AM 4:00 PM

Main Conference Registration

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)

Join CMS representatives as they discuss the latest HHS-Operated Risk Adjustment and Risk Adjustment Data Validation Updates. This conversation will include an overview of the risk adjustment and risk adjustment data validation policies in the proposed 2023 Payment Notice and a progress report on 2019 and 2020 HHS-RADV processes  

Allison Yadsko, Deputy Director, Division of Policy and Analysis
Centers for Medicare & Medicaid Services (CMS)

Catherine Anderson, Deputy Director, Division of Risk Adjustment Operations
Centers for Medicare & Medicaid Services (CMS)

Joshua Paul, Risk Adjustment and HHS-RADV Technical Lead
Centers for Medicare & Medicaid Services (CMS)

10:45 AM 11:30 AM

9:45 AM 10:30 AM

8:45 AM 9:30 AM

7:45 AM 8:30 AM

2022 Update from the Office of the Inspector General (OIG)

Presenters will provide an overview of OIG’s recent reports and current priorities in the managed care space. Topics will include chart reviews and health risk assessments, as well as industry responses to OIG risk adjustment data validation audits. The panel will also take a deep dive into the use of Medicare Advantage encounter data for program integrity. 

Megan H. Tinker, Assistant Inspector General 
Office of Inspector General 
U.S. Department of Health and Human Services (HHS) 

Jacqualine Reid, Social Science Research Analyst 
Office of Inspector General 
U.S. Department of Health and Human Services (HHS) 

Robert E. Kirkner, Social Science Research Analyst for Evaluation and Inspections 
Office of Inspector General 
U.S. Department of Health and Human Services (HHS) 

 

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 Trends

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 

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

 

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

Rachel Sterner, MPH, Stars Program Manager
UCare

 

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, Vice President Product Management 
Edifecs

 

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 Quest Diagnostics Senior Clinical 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

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

Nicholaos C. Bellos, MD, FIDSA, FACP, Medical Director, Extended Care Svc Franchise
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

Laurin Dixon, Lead Executive - Medicare Products
Arkansas BCBS 

Michael Schopke, Chief Growth Officer
DataLink Software 

12:35 PM 1:20 PM

11:35 AM 12:20 PM

10:35 AM 11:20 AM

9:35 AM 10:20 AM

Turning Compliance into Opportunity: How Payers Can Create Growth from the 21st Century Cures Act

Strategy & Innovation
  • Easily ingesting and normalizing new data about your members while complying with mandated standards.
  • Applying the new data sources to drive risk adjustment, new member enrollmentand/or gaps in care strategies 
  • Reducing the burden and cost of managing your patient access API ecosystem 

Jay Sultan, Vice President, Healthcare Strategy 
LexisNexis Risk Solutions

Josh Weisbrod, Vice President Risk Adjustment
Network Health  

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

Transformative AI: Advancing Insights That Impact Lives

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 

Milan Vyas, Senior Vice President of Value Based Care
MyCare Medical

Brian McCarthy, Board Member
ATRIO Health Plans

Roshan Desai, Chief Financial 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
  • Understand the soft and hard impacts to Bid and member satisfaction

Dave Etling, Senior Vice President & General Manager 
InComm

Hannah Neylon, Manager, Government Products and Relations
Network Health

 

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

2:15 PM 3:00 PM

1:15 PM 2:00 PM

12:15 PM 1:00 PM

11:15 AM 12:00 PM

Three Best Practices for Closing Care Gaps in 2022 with At-Home Tests

Quality, HEDIS® and Stars
  • Reach your patients where they’re most comfortable—at home. And make it personal
  • Use technology to automate your communication campaign and your patient’s journey
  • Use a systematic approach and mail kits throughout the year

Dan Ablett, President
Previon Solutions, LLC

Adele L. Towers, MD MPH FACP, Associate Professor of Medicine and Psychiatry, Director, Risk Adjustment
UPMC Enterprises

2:15 PM 3:00 PM

1:15 PM 2:00 PM

12:15 PM 1:00 PM

11:15 AM 12:00 PM

Turning Up the Heat on CAHPS to Boost Member Satisfaction — Real Stories from National & Regional Plans

Strategy & Innovation
  • The need to understand and address human components in outreach to maximize the experience and drive action
  • How leading health plans are deploying engagement programs that produce measurable results and ROI 
  • How national and regional health plans think differently about their member satisfaction strategy

Steve Wigginton, CEO
Icario

Jason Sloan, Medicare Stars Performance Officer
BCBS of South Carolina

Brian Krajewski, Managing Director, Member Solutions and Administration
Blue Cross Blue Shield of Michigan / Senior Health Services

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
  • Explore how the shift toward clinical data extraction at scale enables different thinking about operational approaches
  • Discuss approaches that help solve for new member data acquisition
  • Understand the drivers for and competencies required in increasing the utility of acquired clinical data
  • Begin preparing for potential inclusion of SDoHin the CMS HCC Risk Adjustment model

Moderator:
David Meyer, Member
RISE Policy Committee

Bill Horn, Senior Vice President of Payer Growth
Ciox Health / Datavant

Scott Weiner, Director, Government Programs
Sentara

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 

Moderator:
Adele L. Towers, MD MPH FACP, Associate Professor of Medicine and Psychiatry, Director, Risk Adjustment
UPMC Enterprises

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

When Galaxies Collide - Achieving Integrated Quality and Risk Program Excellence

Technology/Data Analytics
  • Explore the current universe of siloed quality and risk programs and the merits of moving to an integrated approach 
  • Discover how an integrated analytics strategy empowers providers and positively impacts outcomes 
  • Identify key steps for fostering successful organizational change and support of an integrated program

Moderator:
Courtney Breece, Sr. Director, Product Management
Inovalon

Speakers:

Dr. Paige Kilian, Chief Medical Officer
Inovalon

James Clement, Vice President, Product & Services
Inovalon

Kevin Greer, Director, Medicare and ACA Risk Adjustment Programs and Analysis
AmeriHealth

Leah Hannum, Director of Government Funding
BlueCross of Idaho

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
  • Understand the role informal caregivers fulfill within the dynamics of member care plans that encompass medical and medication objectives
  • Discover how the informal caregiver can assist in obtaining timely and updated member diagnoses that will contribute to accurately computed risk scores and quality measures
  • Learn how the active engagement of informal caregivers into members' daily lives drives the overall physical and behavioral health and wellbeing of the member 
  • Gain insight into the symbiotic relationship between caregivers and providers and how this relationship promotes a "best practice" of care plan initiatives

Richard Lieberman, Chief Executive Officer
Cortex Analytics, Inc. / Mile High Healthcare Consulting, LLC

Ramin Gozleveli, President
Innovative Medical Solutions, LLC

3:20 PM 4:05 PM

2:20 PM 3:05 PM

1:20 PM 2:05 PM

12:20 PM 1:05 PM

From Steps to 24/7 Health Companion: How Today’s Health Tech Can Help You Acquire, Engage and Retain Members

Strategy & Innovation
  • Discuss the latest trends in health tech among all age and risk groups
  • Learn how today’s robust data services drive greater integration across interventions and programs
  • Discover how today’s wearable technology supports highly personalized health and wellbeing experiences and drive positive health outcomes
  • Gain best practices and hear examples for using today’s wearable technology to acquire, engage and retain members 

Amy McDonough, Managing Director and General Manager
Fitbit Health Solutions| Google

Kapil Parakh, MD, PhD, Medical Lead
Fitbit | Google

William Shrank, Chief Medical Officer
Humana 

Vandna Pandita, Vice President, HEDIS Strategy & Analytics
AmeriHealth Caritas

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

Strategies for the Implementation of AI for a Successful Value-Based Care Program

Risk Adjustment Strategies
  • Discuss critical technological components of a successful Value-Based Care Program 
  • Assess how structured and unstructured patient data is being accessed and applied within the healthcare continuum 
  • Gain insight on how to best integrate an AI platform into your organizations Value-Based Care Program to improve patient outcomes and decrease physician burnout 
  • Hear how one company is utilizing an AI platform to improve and better coordinate the way they are delivering and measuring healthcare 

Chad Wege, Director, Product Management
Apixio

Kelley Scott, MSN FNP-c, Nurse Practitioner
Providence St Joes

Alan Sun, Vice President of Product
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: Improved Financial Performance and Payment Integrity using NLP

Compliance and Regulatory Updates

• New AI reimagines claims validation
• CMS strategies for automating review of Medicare claims
• With NLP, financial performance and compliance are friends 

Jim Parker
Former Senior Advisor to the Secretary of HHS for Health Reform

Melanie Combs-Dyer
Former Director, Provider Compliance Group, Center for Program Integrity, CMS

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
  • Understand current market dynamics and the challenges that payers and providers are experiencing as they transition to value-based care 
  • Learn how greater payer and provider collaboration can drive value-based care performance 
  • Hear directly from a payer and provider about the benefits of provider-centric risk adjustment and quality programs, including higher compliance, improved quality of care, and better financial performance   

Josh Stern, Chief Revenue Officer 
Vatica Health

John M. Barkley, Vice President, Enterprise Risk Adjustment & Data Integrity
EmblemHealth/ConnectiCare

Margaret Paroski, MD, MMM, President & CEO and Chief Medical Officer
Catholic Medical Partners 

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 

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

Will Stabler, Executive Vice President, Payer Solutions
GeBBS Healthcare Solutions

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
  • Understand how streamlining workflows with a platform approach leads to more accurate risk scores, reduced provider abrasion, and improved patient care
  • Learn how better data insights can help prioritize the most impactful interventions and make your organization more efficient and effective
  • Identify the three key factors to look for in a risk adjustment platform and vendor partner

Vinitha Ramnathan, Senior Vice President, Product
Episource

Amber Harris, CPC, CRC, Director of Risk Adjustment
MediGold

Mike Sloan, Manager, Risk Adjustment Submissions and Analytics
MediGold

4:10 PM 4:55 PM

3:10 PM 3:55 PM

2:10 PM 2:55 PM

1:10 PM 1:55 PM

Equity From End-to-End: Transformative Strategies to Power Impactful SDoH Programs

Social Determinants of Health
  • Uncover the impact of social and health care on health disparities in the community, and understand the value of social determinants of health (SDoH) in targeting health equity at all stages of care, impacting health outcomes and cost, and driving program transformation from end-to-end
  • Learn how SDoH data help flexibly and continuously deploy social interventions, drives additional resource investment to close existing gaps, and informs future improvements to SDoH programming
  • Discover how one health plan leverages SDoH data to solve for member health outcomes, from identifying, engaging, and referring members for the social care interventions they need most, to employing robust SDoH data to measure and invest in health equity impact

Kurt Waltenbaugh, Senior Vice President Insights + Growth 
Unite Us

Tracy Parris-Benjamin (She/her/hers), LMSW, FHELA, Dir, Clinical Design Community Health
Horizon Blue Cross Blue Shield of New Jersey

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

Sponsored By 

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 

Moderator:
Venkat Kavarthapu, CEO
Edifecs

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

 

Interactive Roundtables Part One 5:50 PM - 6:50 PM 4:50 PM - 5:50 PM 3:50 PM - 4:50 PM 2:50 PM - 3:50 PM

5:50 PM 6:50 PM

4:50 PM 5:50 PM

3:50 PM 4:50 PM

2:50 PM 3:50 PM

What's a Roundtable?

Interactive Roundtables

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. 

5:50 PM 6:50 PM

4:50 PM 5:50 PM

3:50 PM 4:50 PM

2:50 PM 3:50 PM

Reduce Senior Isolation and Loneliness with on Demand Companionship

Roundtable A

5:50 PM 6:50 PM

4:50 PM 5:50 PM

3:50 PM 4:50 PM

2:50 PM 3:50 PM

How Artificial Intelligence, NLP, and Intelligent Automation can supercharge your Risk Adjustment and Quality Improvement programs

Roundtable B

5:50 PM 6:50 PM

4:50 PM 5:50 PM

3:50 PM 4:50 PM

2:50 PM 3:50 PM

How Health Plans Are Leveraging Digital Communications and a High-Touch Appointment-based Model to Transform Member Health Outcomes, Quality Scores & Ratings – Drive Plan Performance

Roundtable C

5:50 PM 6:50 PM

4:50 PM 5:50 PM

3:50 PM 4:50 PM

2:50 PM 3:50 PM

How to Minimize Member Disenrollment at the end of the Public Health Emergency

Roundtable D

5:50 PM 6:50 PM

4:50 PM 5:50 PM

3:50 PM 4:50 PM

2:50 PM 3:50 PM

What barriers are preventing you from providing proactive SDoH interventions?

Roundtable E

 

5:50 PM 6:50 PM

4:50 PM 5:50 PM

3:50 PM 4:50 PM

2:50 PM 3:50 PM

Fulfill HEDIS Measures and Improve STAR Ratings Through Reliable Osteoporosis Screening

Roundtable F

5:50 PM 6:50 PM

4:50 PM 5:50 PM

3:50 PM 4:50 PM

2:50 PM 3:50 PM

Operationalizing an HCC Process within a Provider Organization:  A Framework for Success

Roundtable G

5:50 PM 6:50 PM

4:50 PM 5:50 PM

3:50 PM 4:50 PM

2:50 PM 3:50 PM

Beyond Benefits: Differentiating your Plan’s Supplemental Benefit Strategy for 2023 to Optimize Growth, Outcomes, Cost Savings, and Member Experience

Roundtable H

5:50 PM 6:50 PM

4:50 PM 5:50 PM

3:50 PM 4:50 PM

2:50 PM 3:50 PM

What are your Risk Adjustment Reviews telling you? Actionable ways to Review your Data Utilizing Technology

Roundtable I

5:50 PM 6:50 PM

4:50 PM 5:50 PM

3:50 PM 4:50 PM

2:50 PM 3:50 PM

Live Fast, Live Easy Live Well: Build Member Loyalty and Grow your Bottom Line with Medline's OTC Benefit Solution - LiveWell.

Roundtable J

5:50 PM 6:50 PM

4:50 PM 5:50 PM

3:50 PM 4:50 PM

2:50 PM 3:50 PM

Make Care Accessible From Home to Improve Quality Ratings

Roundtable K

5:50 PM 6:50 PM

4:50 PM 5:50 PM

3:50 PM 4:50 PM

2:50 PM 3:50 PM

Your Medicare Advantage Growth Strategy: Find New m\Markets, Drive More Revenue  

Roundtable L

5:50 PM 6:50 PM

4:50 PM 5:50 PM

3:50 PM 4:50 PM

2:50 PM 3:50 PM

Data Driven Insights for Stars/Quality Improvement

Roundtable M

5:50 PM 6:50 PM

4:50 PM 5:50 PM

3:50 PM 4:50 PM

2:50 PM 3:50 PM

Wait. Don't delete, yet. Addressing a Common Compliance Misinterpretation.

Roundtable N

5:50 PM 6:50 PM

4:50 PM 5:50 PM

3:50 PM 4:50 PM

2:50 PM 3:50 PM

Accelerating MA Strategy Performance with a Unified Payer-Provider Data Platform: An Interactive Demo Experience

Roundtable O

5:50 PM 6:50 PM

4:50 PM 5:50 PM

3:50 PM 4:50 PM

2:50 PM 3:50 PM

Care Anywhere - An OmniChannel approach to care delivery

Roundtable P

5:50 PM 6:50 PM

4:50 PM 5:50 PM

3:50 PM 4:50 PM

2:50 PM 3:50 PM

How to Value and Grow the Value of your Medicare Agency to Sell it 

Roundtable Q

5:50 PM 6:50 PM

4:50 PM 5:50 PM

3:50 PM 4:50 PM

2:50 PM 3:50 PM

Innovative Supplemental Sleep Benefit to Improve Outcomes of Medicare Beneficiaries

Roundtable R

5:50 PM 6:50 PM

4:50 PM 5:50 PM

3:50 PM 4:50 PM

2:50 PM 3:50 PM

How to Attract & Retain Your Members Through Technology Offerings | A Supplemental Benefits Discussion

Roundtable S

5:50 PM 6:50 PM

4:50 PM 5:50 PM

3:50 PM 4:50 PM

2:50 PM 3:50 PM

Feeling the Weight of Stars Ratings? Discover Technology to Improve Program Effectiveness and Increase Member Satisfaction

Roundtable T

5:50 PM 6:50 PM

4:50 PM 5:50 PM

3:50 PM 4:50 PM

2:50 PM 3:50 PM

Enabling Coordinated and Connected Care across Post-Acute, Home, and Community Settings

Roundtable U

5:50 PM 6:50 PM

4:50 PM 5:50 PM

3:50 PM 4:50 PM

2:50 PM 3:50 PM

Best in KLAS for Risk Adjustment & Best in Class for our Clients: A Case Study on How EXL Helps Clients Exceed Expectations

Roundtable V

5:50 PM 6:50 PM

4:50 PM 5:50 PM

3:50 PM 4:50 PM

2:50 PM 3:50 PM

From Claims to Members Health WHY, Meet the First Health Behavior Management Software

Roundtable W

5:50 PM 6:50 PM

4:50 PM 5:50 PM

3:50 PM 4:50 PM

2:50 PM 3:50 PM

Assessing Performance and Compliance: The Benefits of a Quantitative and Qualitative Risk Adjustment Assessment

Roundtable X

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 3:15 PM

7:30 AM 2:15 PM

6:30 AM 1:15 PM

5:30 AM 12:15 PM

Main Conference Registration

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

Interactive Roundtables Part Two 9:00 AM - 10:00 AM 8:00 AM - 9:00 AM 7:00 AM - 8:00 AM 6:00 AM - 7:00 AM

9:00 AM 10:00 AM

8:00 AM 9:00 AM

7:00 AM 8:00 AM

6:00 AM 7:00 AM

What's a Roundtable?

Interactive Roundtables

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. 

9:00 AM 10:00 AM

8:00 AM 9:00 AM

7:00 AM 8:00 AM

6:00 AM 7:00 AM

Identifying and Reducing Peripheral Neuropathy Risk in Medicare Advantage

Roundtable A

9:00 AM 10:00 AM

8:00 AM 9:00 AM

7:00 AM 8:00 AM

6:00 AM 7:00 AM

Understanding Overpayments and OIG involvement in Risk Adjustment

Roundtable B

9:00 AM 10:00 AM

8:00 AM 9:00 AM

7:00 AM 8:00 AM

6:00 AM 7:00 AM

Deploying a Hybrid Care Delivery Model to Maximize Member Engagement and Retention

Roundtable C

9:00 AM 10:00 AM

8:00 AM 9:00 AM

7:00 AM 8:00 AM

6:00 AM 7:00 AM

Taking the Pulse: Is the 65+ Adult Population Engaging in Digital Health?

Roundtable D

9:00 AM 10:00 AM

8:00 AM 9:00 AM

7:00 AM 8:00 AM

6:00 AM 7:00 AM

Tackling the Challenges of COPD Management

Roundtable E

9:00 AM 10:00 AM

8:00 AM 9:00 AM

7:00 AM 8:00 AM

6:00 AM 7:00 AM

Boosting HCC Capture and Gap Closure during Clinical Encounters with Point-of-Care Technology

Roundtable F

9:00 AM 10:00 AM

8:00 AM 9:00 AM

7:00 AM 8:00 AM

6:00 AM 7:00 AM

Hallmark Cards Improve Member Satisfaction and Increase Quality Scores: Stars, HEDIS, CAHPS, and HOS. 

Roundtable G

9:00 AM 10:00 AM

8:00 AM 9:00 AM

7:00 AM 8:00 AM

6:00 AM 7:00 AM

The Last Mile: Using Virtual Care to Maximize Stars Performance

Roundtable H

9:00 AM 10:00 AM

8:00 AM 9:00 AM

7:00 AM 8:00 AM

6:00 AM 7:00 AM

Engaging the Provider on Complete Documentation

Roundtable I

9:00 AM 10:00 AM

8:00 AM 9:00 AM

7:00 AM 8:00 AM

6:00 AM 7:00 AM

Redefining Risk: Leverage AI to improve Clinical Program ROI

Roundtable J

9:00 AM 10:00 AM

8:00 AM 9:00 AM

7:00 AM 8:00 AM

6:00 AM 7:00 AM

Population Analytics and Scalable RPM: 1+1=3 for Value-Based Care

Roundtable K

9:00 AM 10:00 AM

8:00 AM 9:00 AM

7:00 AM 8:00 AM

6:00 AM 7:00 AM

Leveraging AI to Optimize Chart Review and Compliance

Roundtable L

9:00 AM 10:00 AM

8:00 AM 9:00 AM

7:00 AM 8:00 AM

6:00 AM 7:00 AM

Improving Compliance and Outcomes Through Care Collaboration

Roundtable M

9:00 AM 10:00 AM

8:00 AM 9:00 AM

7:00 AM 8:00 AM

6:00 AM 7:00 AM

How Can I Monitor Ongoing Member Experience Like I Do Quality of Care?

Roundtable N

9:00 AM 10:00 AM

8:00 AM 9:00 AM

7:00 AM 8:00 AM

6:00 AM 7:00 AM

The Future of Revenue Integrity: Pre-Encounter Chart Review

Roundtable O

9:00 AM 10:00 AM

8:00 AM 9:00 AM

7:00 AM 8:00 AM

6:00 AM 7:00 AM

Better Access to Provider Data/Charts for Risk Adjustment and Quality Initiatives

Roundtable P

9:00 AM 10:00 AM

8:00 AM 9:00 AM

7:00 AM 8:00 AM

6:00 AM 7:00 AM

Tour HCC Coder With A Power User

Roundtable Q

9:00 AM 10:00 AM

8:00 AM 9:00 AM

7:00 AM 8:00 AM

6:00 AM 7:00 AM

Improve HEDIS®, STAR Quality Performance by Increasing Access to the Diabetic Eye Exam

Roundtable R

9:00 AM 10:00 AM

8:00 AM 9:00 AM

7:00 AM 8:00 AM

6:00 AM 7:00 AM

Risk Adjustment Paradigm Shift: More Robust Clinical Data, No Provider Friction, and Exceptional Cost Efficiency

Roundtable S

          

9:00 AM 10:00 AM

8:00 AM 9:00 AM

7:00 AM 8:00 AM

6:00 AM 7:00 AM

Advancing to Member-Centered Risk Adjustment in a Post-COVID Landscape

Roundtable T

9:00 AM 10:00 AM

8:00 AM 9:00 AM

7:00 AM 8:00 AM

6:00 AM 7:00 AM

Enhancing Payer-Provider Collaboration at the Highest Level Inside the EHR

Roundtable U

9:00 AM 10:00 AM

8:00 AM 9:00 AM

7:00 AM 8:00 AM

6:00 AM 7:00 AM

Discussion: Breaking Market Barriers with a Powerful Tech-Enabled Strategy

Roundtable V

9:00 AM 10:00 AM

8:00 AM 9:00 AM

7:00 AM 8:00 AM

6:00 AM 7:00 AM

Pet Telehealth: Why It’s So Important for the Wellbeing of your Members

Roundtable W

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: Changing the Future: Applying Gaming to Health Care

Jane will discuss how we can apply gaming to health care.  It can be as simple as lessons on user interface, engaging patients, the effective use of rewards, or something more profound.  Jane has worked with the CDC and US Army on using games to heal, and with the Robert Wood Johnson Foundation on using games to improve medical research.  SuperBetter has just been shown to be successful in using smart-phone interventions to treat depression and anxiety.  Jane has been named one of the 100 most creative people in business, as well as one of the most innovative voices by Business Week and MITTechnology Review.   

Jane McGonigal, Director of Game Research and Development  
Institute For The Future 
Author of SuperBetter: How Gameful Living Makes You Stronger, Happier, Braver and More Resilient and Reality is Broken:  Why games make us happy and how we they can change the world.   

 

All RISE Association members will receive a complimentary copy of Jane's new book, Imaginable: How to See the Future Coming and Feel Ready For Anything - Even Things That Seem Impossible Today

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 

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

Ashley Tyrner, Founder and CEO
FarmboxRx

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

Changing The Way We Evaluate Quality in Healthcare Delivery

Digital Health Care Delivery
  • How healthcare is delivered and experienced is changing, largely due to the COVID-19 pandemic, but also driven by changes in consumer behaviors and demands. We also need to change how we think about and evaluate quality
  • Hear about new ways to think about "quality" in healthcare, including access to care, provider diversity and cultural competence, and (of course) outcomes 
  • Learn how innovative health plans are leveraging new solutions to remain competitive, while addressing key member needs around access, diversity, and experience

Dr. Ian Tong, Chief Medical Officer
Included Health

Jim Gallagher, Vice President Product Strategy & Innovation
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

Next Gen Risk Adjustment Solutions Taking Hold Across the Country

Technology/Data Analytics
  • Explore the changing space of risk adjustment – emerging and new solutions being rolled out across the country to address critical needs
  • Essential tips for prospective opportunities to identify and close gaps 
  • Harness retrospective, multifaceted chart retrieval modalities to drive quality and yield

Lynne Padilla, Vice President of Risk Adjustment Solutions
Change Healthcare

Jimmy Liu, Vice President of Risk Analytics
Change Healthcare

Ana Handshuh, Principal
CAT5 Strategies

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  

Jill Tays RN, BSN, Director of Case Management, Coding, CDI
Magnolia Regional Health Center

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 Lunch 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.

Art Diaz, Vice President, Performance and Quality
Centrum 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

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

Max Voldman, Attorney
Constantine Cannon LLP

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 

Moderator:
Kevin M. Healy, CEO
Allymar Health Solutions

Ana Handshuh, Principal
CAT5 Strategies

Patrick Coulson, Chief Growth Officer
Advantasure

Anne Stowell, Vice President Product Consumer Experience
Signify Health

Lou Steinberg, Senior Vice President, Payer Market Sales
Apixio

Dawn Carter, Director, Product Strategy
Centauri Health Solutions

Kent M. Holdcroft, MA, Executive Vice President, Growth
HealthMine

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

Jeremy Stone,
Senior Vice President, Population Health Solutions
Everly Health Solutions

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