RISE National 2023 features 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's in store March 6-8, 2023 in Colorado Springs.
10:00 AM 11:00 AM
9:00 AM 10:00 AM
8:00 AM 9:00 AM
7:00 AM 8:00 AM
11:00 AM 6:00 PM
10:00 AM 5:00 PM
9:00 AM 4:00 PM
8:00 AM 3:00 PM
11:00 AM 5:00 PM
10:00 AM 4:00 PM
9:00 AM 3:00 PM
8:00 AM 2:00 PM
Instructors:
Laura Sheriff, RN, MSN, Vice President Operations, Risk Adjustment
Southwestern Health Resources (SWHR)
Susan Waterman, RHIT, CCS, CPC, CRC, AHIMA ICD-10-CM/PCS, Trainer, Director, Risk Adjustment
Baylor Scott & White
11:00 AM 5:00 PM
10:00 AM 4:00 PM
9:00 AM 3:00 PM
8:00 AM 2:00 PM
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
Instructor:
Colleen Gianatasio, Clinical Documentation Integrity and Coding Compliance
Capital District Physician’s Health Plan (CDPHP)
3:00 PM 6:00 PM
2:00 PM 5:00 PM
1:00 PM 4:00 PM
12:00 PM 3:00 PM
Jason Eric Christ, JD, Attorney
Epstein Becker Green
David Meyer, CCO, Applied Research Works/Cozeva
Advisor, EBG
2:00 PM 6:00 PM
1:00 PM 5:00 PM
12:00 PM 4:00 PM
11:00 AM 3:00 PM
This workshop will be divided in three topics:
Setting the Shared Destination: Aligned Program Objectives
David DeHommel, Managing Director of Risk Adjustment
BCBS of Michigan
Scott Stratton, MPH, Chief Data Scientist & VP Industry Development
Veradigm
Choosing the Routes: Engaging Providers Where They Are
Bruce Waugaman, Risk Adjustment Leader
EmblemHealth
Meghan West, Sr. Manager Product Management, Clinical Data Exchange
Veradigm
Getting the Most Out of Your Destination: Submissions and More
Lisa Pouncey, Director Product Management, Data Transformation and Submissions
Veradigm
Deborah Coakley, Ed.D., MBA, Director, Risk Adjustment Programs – Operations
Baylor Scott & White Health Plan
2:00 PM 6:00 PM
1:00 PM 5:00 PM
12:00 PM 4:00 PM
11:00 AM 3:00 PM
A member-centered approach to Quality, Risk Adjustment, SDOH, and benefits.
As CMS continues its pursuit of the Triple Aim through interoperability and innovation, this workshop will help attendees improve complete and accurate risk adjustment practices through the pursuit of high-quality clinical care. The workshop is designed for risk adjustment, quality, SDOH, finance, and analytics professionals. Join us for an interactive panel and breakout sessions from the leading risk adjustment and quality experts.
John Criswell, Founder, CEO, Chairman
Porter
Melissa Smith, EVP, Consulting & Professional Services
Healthmine
Ana Handhsuh, Principal
Cat 5 Strategies
Dr. Shannon Decker, Principal
VBC One
Liz Haynes, DVP, Risk Adjustment & Stars- Government Programs
Blue Cross and Blue Shield of Kansas City
Daphne Klausner, Plan President
Honest Medical Group
Alyson Spencer, Sr. Director, Clinical Quality
Blue Shield California
Ally Thomas, Ph.D., AVP, Quality Improvement
UPMC Health Plan
6:00 PM 8:00 PM
5:00 PM 7:00 PM
4:00 PM 6:00 PM
3:00 PM 5:00 PM
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.
9:30 AM 11:00 AM
8:30 AM 10:00 AM
7:30 AM 9:00 AM
6:30 AM 8:00 AM
9:30 AM 8:00 PM
8:30 AM 7:00 PM
7:30 AM 6:00 PM
6:30 AM 5:00 PM
9:30 AM 9:30 PM
8:30 AM 8:30 PM
7:30 AM 7:30 PM
6:30 AM 6:30 PM
11:00 AM 11:15 AM
10:00 AM 10:15 AM
9:00 AM 9:15 AM
8:00 AM 8:15 AM
Ellen Wofford, Managing Director
RISE
11:15 AM 12:00 PM
10:15 AM 11:00 AM
9:15 AM 10:00 AM
8:15 AM 9:00 AM
Christi A. Grimm
Inspector General
Office of Inspector General
Department of Health and Human Services
12:00 PM 12:45 PM
11:00 AM 11:45 AM
10:00 AM 10:45 AM
9:00 AM 9:45 AM
The annual regulatory review is back this year to discuss pressing topics such as the Advance Notice, RADV, policy and technology rule updates and their implications for Medicare Advantage as well as Part D. This session will also discuss the Medicaid redetermination and its downstream impact on the ACA marketplaces.
The panel will address expectations around health equity and gaps in care, star rating changes to address disparities, and supplemental benefits utilization, cost and outcomes.
Moderator
Sean Creighton, RISE Policy
Expert Contributor
Greg Gierer, MMP, Vice President of Policy and Research
Better Medicare Alliance
Mikal L. Sutton, Managing Director, Medicaid
Blue Cross Blue Shield Association
12:45 PM 1:15 PM
11:45 AM 12:15 PM
10:45 AM 11:15 AM
9:45 AM 10:15 AM
1:15 PM 2:00 PM
12:15 PM 1:00 PM
11:15 AM 12:00 PM
10:15 AM 11:00 AM
Eric Segal, Sr. Director of Platform Strategy and Solutions
Episource
Roy Oaks, Senior Director, Data Analytics
Driscoll Health Plan
Lisa Marshall, Manager, Alternative Payment Strategies
Driscoll Health Plan
Vinitha Ramnathan,Senior Vice President, Product
Episource
1:15 PM 2:00 PM
12:15 PM 1:00 PM
11:15 AM 12:00 PM
10:15 AM 11:00 AM
Moderator:
Craig Hittle, SVP Health Plans
Kaia Health
Dr. David Shulkin, Ninth Secretary, US Department of Veteran Affairs-Shulkin
Solutions, LLC
Dr. Manoj Pawar, Chief Medical Officer
Mutual of Omaha
Nigel Ohrenstein, President
Kaia Health
1:15 PM 2:00 PM
12:15 PM 1:00 PM
11:15 AM 12:00 PM
10:15 AM 11:00 AM
Khanh Nguyen, PharmD, Chief Executive Officer, Applied Research Works
COZEVA
David Meyer, Chief Customer Officer, Applied Research Works
COZEVA
Rina Shah, MD - Regional Medical Director, Board Member
Hill Physicians Medical Group
1:15 PM 2:00 PM
12:15 PM 1:00 PM
11:15 AM 12:00 PM
10:15 AM 11:00 AM
Elissa Toder, VP, Quality Improvement Strategy & Solutions
Reveleer
Deniese Crittenden, RN, MSN, MHA, BSW, CRC, Vice President, Risk Adjustment Strategy and Solutions
Reveleer
1:15 PM 2:00 PM
12:15 PM 1:00 PM
11:15 AM 12:00 PM
10:15 AM 11:00 AM
Belinda Marcel, VP, Member Engagement
Matrix Medical Network
1:15 PM 2:00 PM
12:15 PM 1:00 PM
11:15 AM 12:00 PM
10:15 AM 11:00 AM
Presenters will provide an overview of OIG’s recent reports and current priorities in the managed care space. Topics will include OIG risk adjustment data validation audits as well as Medicare Advantage Organizations’ denials of payments and services. The panel will also outline future work regarding health disparities.
Moderator:
Ana Handhsuh, Principal
Cat 5 Strategies
Megan H. Tinker, Chief of Staff
Office of Inspector General
U.S. Department of Health and Human Services (HHS)
Blaine Collins, Regional Inspector General, Office of Evaluation and Inspections
Office of Inspector General
U.S. Department of Health and Human Services (HHS)
Jacqualine Reid, Social Science Research Analyst , Office of Evaluation and Inspections
Office of Inspector General
U.S. Department of Health and Human Services (HHS)
2:00 PM 2:55 PM
1:00 PM 1:55 PM
12:00 PM 12:55 PM
11:00 AM 11:55 AM
3:00 PM 3:45 PM
2:00 PM 2:45 PM
1:00 PM 1:45 PM
12:00 PM 12:45 PM
George Witwer, CEO
Cavo Health
Troy Garland, MBA, BA, RN, Vice President Clinical and Quality Operations
Equality Health
P.J. Morris, MHA, Manager, Risk Adjustment Operations & Analytics
Fallon Health
3:00 PM 3:45 PM
2:00 PM 2:45 PM
1:00 PM 1:45 PM
12:00 PM 12:45 PM
Michael Hasbany, EVP of Sales and Commercialization
Inovalon
Matthew Caminiti, Sr. Principal Solutions Engineer
Inovalon
Gabriel L. Medley, Vice President, Risk Adjustment & Analytics
Blue Cross Blue Shield of Michigan
Shontelle Mixon, CPA, MBA, Vice President – Enablement
Health Care Service Corporation
3:00 PM 3:45 PM
2:00 PM 2:45 PM
1:00 PM 1:45 PM
12:00 PM 12:45 PM
Dr. Shannon Decker, Principal
VBC One
3:00 PM 3:45 PM
2:00 PM 2:45 PM
1:00 PM 1:45 PM
12:00 PM 12:45 PM
Aria Sameni, Vice President of Growth and Strategy
Optum
James Hereford, Chief Executive Officer
M Health Fairview
3:00 PM 3:45 PM
2:00 PM 2:45 PM
1:00 PM 1:45 PM
12:00 PM 12:45 PM
Moderator
Ashish Kachru, CEO
DataLink Software
James D. Murray, MS, VP, Clinical Informatics and Interoperability
CVS Health/Aetna
Josh Hetler, Executive Vice President, Business Intelligence
DataLink Software
3:00 PM 3:45 PM
2:00 PM 2:45 PM
1:00 PM 1:45 PM
12:00 PM 12:45 PM
Debbie Conboy, SVP, Risk Adjustment and Quality
Signify
Lynne Newson, Vice President, Medicare Strategy
Blue Cross Blue Shield of Massachusetts
3:45 PM 4:15 PM
2:45 PM 3:15 PM
1:45 PM 2:15 PM
12:45 PM 1:15 PM
4:15 PM 5:00 PM
3:15 PM 4:00 PM
2:15 PM 3:00 PM
1:15 PM 2:00 PM
Kelley Scott MSN FNP-c, Nurse Practitioner at Providence Medical Foundation
Providence St. Joseph Health
Matt Plack, VP for Innovation and New Solution Strategy
Apixio
4:15 PM 5:00 PM
3:15 PM 4:00 PM
2:15 PM 3:00 PM
1:15 PM 2:00 PM
Michelle Zilisch, Director, Product Management
Ciox Health/Datavant
Lyle Mioduszewski, Vice President of Population Health
Ciox Health
Susan Waterman, RHIT, CCS, CPC, CRC, AHIMA ICD-10-CM/PCS, Trainer, Director, Risk Adjustment
Baylor Scott & White
4:15 PM 5:00 PM
3:15 PM 4:00 PM
2:15 PM 3:00 PM
1:15 PM 2:00 PM
Francesca Rinaldo, MD, PhD, SVP, Clinical Product & Innovation
Sharecare
Jessica Wack-Alexander, MBA, Program Manager, Health Care Services
Providence Health Plan
4:15 PM 5:00 PM
3:15 PM 4:00 PM
2:15 PM 3:00 PM
1:15 PM 2:00 PM
Mark Filiault, VP Payer Sales
Edifecs
4:15 PM 5:00 PM
3:15 PM 4:00 PM
2:15 PM 3:00 PM
1:15 PM 2:00 PM
FTI consulting
4:15 PM 5:00 PM
3:15 PM 4:00 PM
2:15 PM 3:00 PM
1:15 PM 2:00 PM
Lynne Padilla, Vice President, Risk Adjustment Solutions
Change Healthcare
Leo Janze, Head of Data Engineering, NLP
Change Healthcare
Laura Sheriff, RN, MSN, Vice President Operations, Risk Adjustment
Southwestern Health Resources (SWHR)
5:05 PM 5:50 PM
4:05 PM 4:50 PM
3:05 PM 3:50 PM
2:05 PM 2:50 PM
Dawn Carter, BSBA, CPC, Director, Product Strategy
Centauri Health Solutions
Melissa McVaugh MSN-LM, RN, CPC, Director Clinical Programs
Mountain Health CO-OP
5:05 PM 5:50 PM
4:05 PM 4:50 PM
3:05 PM 3:50 PM
2:05 PM 2:50 PM
Moderator
Patrick Coulson, Senior Vice President, Sales and Marketing
Allymar Health Solutions
Kevin M. Healy, CEO
Allymar Health Solutions
Gregg Kimmer, CEO
ATRIO
5:05 PM 5:50 PM
4:05 PM 4:50 PM
3:05 PM 3:50 PM
2:05 PM 2:50 PM
David L. Larsen RN MHA, Senior Advisor Payor Solutions
Press Ganey
5:05 PM 5:50 PM
4:05 PM 4:50 PM
3:05 PM 3:50 PM
2:05 PM 2:50 PM
Hassan Rifaat, MD, Chief Executive Officer
Vatica Health
Steve Romary, Director, Risk Adjustment Programs and Strategy
Highmark
Paul Linder, MD
Paul G. Linder and Associates PC
5:05 PM 5:50 PM
4:05 PM 4:50 PM
3:05 PM 3:50 PM
2:05 PM 2:50 PM
Troy Jelinek, Chief Commercial Officer
Icario
Jennie Roberts, Senior VP, Quality and Clinical Modernization UnitedHealthcare
5:05 PM 5:50 PM
4:05 PM 4:50 PM
3:05 PM 3:50 PM
2:05 PM 2:50 PM
Moderator:
Dr. Shannon Decker, Principal
VBC One
Robert London, MD, Medical Director
Semler Scientific, Inc.
Wayne Pan, MD, PhD, MBA, Medical Director
Banner Health
5:55 PM 6:45 PM
4:55 PM 5:45 PM
3:55 PM 4:45 PM
2:55 PM 3:45 PM
Facilitated by UC Berkeley faculty, Dr. Yousef and Professor Miller, this discussion will help equip you with the knowledge you need to both think more strategically and get more work done when time and resources are limited.
We will cover:
Dr. Sahar Yousef, Cognitive Neuroscientist
Faculty Member
UC Berkeley’s Haas School of Business
Professor Lucas Miller, Faculty Member
UC Berkeley’s Haas School of Business
6:50 PM 7:50 PM
5:50 PM 6:50 PM
4:50 PM 5:50 PM
3:50 PM 4:50 PM
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.
7:50 PM 9:00 PM
6:50 PM 8:00 PM
5:50 PM 7:00 PM
4:50 PM 6:00 PM
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.
9:30 AM 11:00 AM
8:30 AM 10:00 AM
7:30 AM 9:00 AM
6:30 AM 8:00 AM
9:30 AM 4:15 PM
8:30 AM 3:15 PM
7:30 AM 2:15 PM
6:30 AM 1:15 PM
9:30 AM 3:30 PM
8:30 AM 2:30 PM
7:30 AM 1:30 PM
6:30 AM 12:30 PM
11:00 AM 11:05 AM
10:00 AM 10:05 AM
9:00 AM 9:05 AM
8:00 AM 8:05 AM
11:05 AM 11:20 AM
10:05 AM 10:20 AM
9:05 AM 9:20 AM
8:05 AM 8:20 AM
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.
11:20 AM 12:20 PM
10:20 AM 11:20 AM
9:20 AM 10:20 AM
8:20 AM 9:20 AM
Brent and Kyle Pease, Ironman Champion Triathletes
This amazing journey started when Kyle watched his brother finish the Louisville triathlon. He counts it as 'one of the most transformative moments in [his] life.' Kyle asked his brother 'Can people in wheelchairs do IRONMAN?' Brent never hesitated with his response; the answer was a resounding 'YES!'. Even though finishing an IRONMAN was something that had never crossed his mind, from that day forward Kyle wanted in.
Allow America's most highly recognized team of brother/brother triathletes take you on their journey from their first race, through the multiple 'NOs', to the final 'YES' from KONA, getting to the start line, the ups and downs to the finish line, and beyond. Hear about growing up Peasey, and how it meant living a life of doing all within your power to succeed, and to also ensure that no single person is ever left on the side-lines.
Through the Pease brothers' unbreakable bond, they show how individual and team focus, determination, and spirit are the keys to achieving and accomplishing feats others might say are impossible. They show you the profound ways a family proved that by illuminating and including individuals with disabilities they were able to find and reveal who they truly are
You will:
12:20 PM 12:40 PM
11:20 AM 11:40 AM
10:20 AM 10:40 AM
9:20 AM 9:40 AM
12:40 PM 1:40 PM
11:40 AM 12:40 PM
10:40 AM 11:40 AM
9:40 AM 10:40 AM
1:45 PM 2:30 PM
12:45 PM 1:30 PM
11:45 AM 12:30 PM
10:45 AM 11:30 AM
In this session we will outline compliance concepts that are important in managing risk adjustment operations.
Anna Carley, RHIT, Senior Director- CRM, Payer Solutions
GeBBS Healthcare Solutions
Will Stabler, Executive Vice President, Payer Solutions
GeBBS Healthcare Solutions
Kathleen Faulk, SVP & General Manager, Government Programs
Regence Blue Cross Blue Shield
1:45 PM 2:30 PM
12:45 PM 1:30 PM
11:45 AM 12:30 PM
10:45 AM 11:30 AM
Jenn Kerfoot, Chief Experience Officer
FarmboxRx
Julianne Eckert RN BSN, CCM, CMCN, ACMP, Senior Director, Clinical Quality Programs
Clover Health
1:45 PM 2:30 PM
12:45 PM 1:30 PM
11:45 AM 12:30 PM
10:45 AM 11:30 AM
Moderator
Brett Hickman, Chief Commercial Officer
Modivcare
Christopher N. Aguwa, Executive Vice President Head of Growth and Business Development
CityBlock Health
Dr. Mohamed Diab, Chief Executive Officer, Accountable Care Organization
CVS Health
Dr. Garth Graham, MD, Director and Global Head of Healthcare and Public Health
Google/YouTube at Alphabet, Inc.
Modivcare Board member
Seth Ravine, Senior Vice President
Modivcare
1:45 PM 2:30 PM
12:45 PM 1:30 PM
11:45 AM 12:30 PM
10:45 AM 11:30 AM
Lisa A. Barrett, Vice President, Member Navigation Solutions My Community Connections
UnitedHealthcare
Sean Libby, President
BeneLynk
1:45 PM 2:30 PM
12:45 PM 1:30 PM
11:45 AM 12:30 PM
10:45 AM 11:30 AM
2:30 PM 3:30 PM
1:30 PM 2:30 PM
12:30 PM 1:30 PM
11:30 AM 12:30 PM
3:30 PM 4:15 PM
2:30 PM 3:15 PM
1:30 PM 2:15 PM
12:30 PM 1:15 PM
Elaine Taverna, Senior Vice President, Risk Adjustment and Quality
Advantasure
Ellen Fink-Samnick, Chair
RISE SDoH Community
3:30 PM 4:15 PM
2:30 PM 3:15 PM
1:30 PM 2:15 PM
12:30 PM 1:15 PM
Moderator:
Erin Montgomery
Advantmed
Eric Hedrick, Vice President, Analytics
Advantmed
Susan Waterman, RHIT, CCS, CPC, CRC, AHIMA ICD-10-CM/PCS, Trainer, Director, Risk Adjustment
Baylor Scott & White
3:30 PM 4:15 PM
2:30 PM 3:15 PM
1:30 PM 2:15 PM
12:30 PM 1:15 PM
Lynda Rowe, Senior Advisor, Value-based Markets
InterSystems
Autumn Kerr, AVP, Clinical Quality
Healthfirst
Kate Beck, AVP, Health Information Exchange
Healthfirst
3:30 PM 4:15 PM
2:30 PM 3:15 PM
1:30 PM 2:15 PM
12:30 PM 1:15 PM
Anna Basevich, VP of Enterprise Partnerships
Arcadia
Laura Sheriff, RN, MSN, Vice President Operations, Risk Adjustment
Southwestern Health Resources (SWHR)
4:15 PM 4:55 PM
3:15 PM 3:55 PM
2:15 PM 2:55 PM
1:15 PM 1:55 PM
As the health care space continues to evolve, join this rapid-fire conversation with health care executives as they discuss upcoming compliance and regulatory changes, trends in technology and data affecting risk adjustment and quality, social determinants of heath, diversity, equity and inclusion, and practical advice to get you ready for the rest of 2023.
Moderator
Vandna Pandita, Vice President, HEDIS Strategy & Analytics
AmeriHealth Caritas
Melanie A. Prince, MSN, BSN, NE-BC, CCM, FCM, FAAN, President/CEO
MAPyourWAY, LLC
Carmela Costiniuk, B.Sc. OT, MHA, D. EdD (C), Vice President, Population Health and Clinical Transformation
Catholic Medical Partners
Margaret Paroski, MD, MMM, President & CEO and Chief Medical Officer
Catholic Medical Partners
4:55 PM 5:00 PM
3:55 PM 4:00 PM
2:55 PM 3:00 PM
1:55 PM 2:00 PM