Join RISE Institute for an in-depth managerial level workshop laying out best practices for an end-to-end method of aligning chart documentation, HCC code capture and audit-readiness at both the provider and health plan levels. There is finally an industry standard through the RISE Institute that shows the “how to” of setting up your department’s workflows, aligning with your provider networks, preparing for RADV audits, and more.
Attendees will walk away with the tools and tactical know-how to:
Donna Malone, CPC, CRC
Senior Manager of Enterprise Risk Adjustment, HCC Coding and Quality Assurance
Tufts Health Plan
Colleen Gianatasio
Director of Ambulatory Clinical Documentation Quality Improvement
Mount Sinai Health System
Medicare Advantage Plans are faced with resounding challenges as a result of the COVID-19 pandemic, with member engagement being at the top of the list. Current CMS guidance allows for using prior HEDIS® and CAHPs survey scores, which may be positive or detrimental to a plan’s success dependent on their position. Moreover, most providers have seen substantially less patients in Q1, so, the big question is, how do you double down on member engagement in the second half of the year to catch up?
Attendees will walk away with the tools and tactical know-how to:
Dr. Shannon Decker, M.Ed., MBA, PhD.
Vice President, Clinical Performance
Brown & Toland Physicians
Dominic Henriques
Vice President of Performance Improvement
Prominence Health Plan
Johanna Martinez
Director of Quality Improvement
Prominence Health Plan
As an update to RISE’s 101 workshop, this advanced version guides attendees in the managerial role of risk adjustment – from running the department to the day-to-day duties – with a primary focus on risk adjustment for the Medicare Advantage line of business.
Upon completion, participants will:
Deb Curry, MBA, RHIA, CCS-P, CRC, Manager, Risk Adjustment
ProMedica
Susan Waterman RHIT CCS CPC CRC, Director of Risk Adjustment
Scott and White Health Plan
Ana Handshuh, CHC, Principal
CAT5 Strategies
Dave Meyer, Vice President, Risk Adjustment and Quality
Cigna
During this motivational talk, Brent compares stories from the battlefield, the lessons learned, and how those lessons apply to leadership during times of crisis, such as COVID-19 hitting the healthcare industry. Brent talks about how to build a culture of leadership, servant leadership, adaptive change management, and much more.
Brent Gleeson
Navy Seal Combat Veteran & Leadership, Culture and Engagement Expert
Former politician John McDonough will give insights into the potential scenarios in the 2020 Presidential Election and subsequent implications for health plans working across Medicare, Medicare Advantage, ACA and Medicaid.
Discuss pressing topics and walk away with an understanding of:
John E. McDonough, DrPH, MPA
Professor of Public Health Practice
Harvard T.H. Chan School of Public Health
Former Member
Massachusetts House of Representatives
Former Senior Advisor on National Health Reform
U.S. Senate Committee on Health
Moderator:
Sean Creighton, Vice President of Federal Policy
Humana
Panelists:
Mark Dodge
AVP of Stars, Risk and Quality
Bright Health Plan
Tom Lutzow
President and CEO
Independent Care Health Plan
Jason McDaniel
Vice President of Risk Adjustment and Quality
Intermountain Healthcare
Yamilet Truex, Manager for Risk Adjustment Data Analytics
Pulse8
Antonette Buenavides, CCS, Director of Risk Adjustment Programs & Audit
SCAN Health
Part I: The Whole Business Model Has Changed
Part II: Operationalizing & on the Ground
Panelists:
Dawn Peterson, CPC, BSPH
Director of Risk Adjustment
Martin’s Point Health Care
Michelle Duran, CPC, CRC
Practice Transformation Facilitator
Hill Physicians Medical Group
Jenni Monfils, CPC, CRC
Risk Adjustment Compliance Coding Manager
UCare
David Weathington
Senior Vice President, Health Plan Operations
Clover Health
Cooper Watts
Senior Director of Clinical Strategy
UnitedHealthcare Medicare & Retirement
Provider Perspective Panel: Keys to Provider / Payer Collaboration in a Post-Pandemic World
Moderator:
Joyce Nuesca, MD, MBA, MS, CPE
Regional Medical Director
Blue Shield of CA
Panelists:
Matthew Anderson
Clinical Innovation Leader
Banner Health
Eric Harman, MD
Physician
Mountain Region Family Medicine
Stephanie Conners, MBA, BSN, RN, NEA-BC
Executive Vice President and Chief Operating Officer
Jefferson Health
Elissa Langley, MHA, VP, Chief Operating Officer
Triad HealthCare Network
Part I: The Whole Business Model Has Changed
Part II: Operationalizing & on the Ground
Panelists:
Dawn Peterson, CPC, BSPH
Director of Risk Adjustment
Martin’s Point Health Care
Michelle Duran, CPC, CRC
Practice Transformation Facilitator
Hill Physicians Medical Group
Jenni Monfils, CPC, CRC
Risk Adjustment Compliance Coding Manager
UCare
David Weathington
Senior Vice President, Health Plan Operations
Clover Health
Cooper Watts
Senior Director of Clinical Strategy
UnitedHealthcare Medicare & Retirement
Mix and Mingle with solution providers and peers to learn the latest and greatest advancements in improving your Risk Adjustment & Quality programs.
Amber Harris, Director Risk Adjustment
MediGold
Mike Sloan, Manager, Risk Adjustment Submissions and Analytics
MediGold
Meleah Bridgeford, Director, Risk Adjustment Analytics
Episource
Monica Watson, RHIA, CPC, CCS, CCS-P, CPMA, CIC, CRC, CDEO, AHIMA ICD-10-CM/PCS
Trainer & Ambassador, Director, Coding Services
Centauri Health Solutions
Tina Tressler CPC
Manager of Coding and Chart Operations
Prominence Health Plan
Join RISE for a special presentation led by Chief Derek Bergsten, Chief Fire Officer and Chief EMS Officer in the second largest Fire Department in the state of IL, as he discusses a success story in partnering with healthcare stakeholders in his community to improve patient outcomes.
In this talk, Chief Bergsten sheds light on how health plans and other healthcare stakeholders can:
Derek Bergsten
Chief
Rockford Fire Department
Ana Handshuh, CHC, Principal
CAT5 Strategies
Dave Meyer, Vice President, Risk Adjustment and Quality
Cigna
Take a breath, calm your nervous system and quiet your mind. Join Yoga veteran, Kim Larkin as she guides attendees through breathing exercises, meditation and a gentle yoga to tart the morning off the right way.
Yoga mats are optional.
Kim Larkin
Yoga & Meditation Instructor
With a flood of inaccurate health headlines vying for your attention every day, it can feel overwhelming to find actionable, accurate tips you can use right here and now. Dr. Milstein’s scientist training will help you to cut through the hype and tap into the latest breakthroughs in science to help you live a healthier, happier life.
Dr. Marc Milstein, PhD
Scientist and Researcher on Health & Happiness
Moderator:
Kathleen Ellmore, Managing Director
Engagys
Member Panelists to be Announced
Mix and Mingle with solution providers and peers to learn the latest and greatest advancements in improving your Risk Adjustment & Quality programs.
Join an intimate Q&A session with NCQA’s VP of Public Policy and External Relations, Frank Micciche, to discuss today's most pressing quality topics, including:
Moderator:
Daniel Weaver, Vice President, Medicare & Medicaid Quality Programs
Gateway Health Plan
Frank Micciche, Vice President of Public Policy and External Relations
NCQA
Join esteemed panelists from the RISE Policy Committee as they break down current regulatory guidelines in the Risk Adjustment and Quality space. Hear a variety of perspectives discuss the real-world implications of telehealth guidance, the pending changes of Star Ratings and advice on staying compliant in an uncertain environment.
Sean Creighton
Vice President of Federal Policy
Humana
Larry Bishoff
President
Laurence Bishoff & Associates
Dave Meyer
Vice President, Risk Adjustment and Quality
Cigna
J. Gabriel McGlamery, J.D.
Senior Health Care Policy Consultant
Florida Blue Center for Health Policy
Howard Weiss
Associate Vice President, Policy
EmblemHealth
Will Dukes, Director of Business Development
iCare Intelligence, Inc.
Daniel Weaver, Vice President, Medicare & Medicaid Quality Programs
Gateway Health Plan
Anticipating a Risk Score Deficit in 2020 and beyond? Well, you’re not alone. Join your peers to benchmark best practices, share tips and strategies in how AI Analytics and other technologies can help close diagnosis and coding gaps. This will be an interactive idea exchange session with other attendees, so, please come ready to ask questions, share challenges in capturing condition shortfall this year and take home tactical ideas to improve your risk capture for 2020 dates of service and beyond.
Session Leader:
Bryan Lee, Vice President of Payer Solutions
Apixio
Co-presenter to be announced
Kristen Viviano, MHA, CPC, CRC
Manager, Risk Adjustment Coding Operations
Capital District Physicians’ Health Plan
Anna Wetherbee, MBA, PMP
Principal, Technology Innovation and Integration
Blue Shield of CA
Dr. Stephen Klasko is a transformative leader and advocate for a revolution in our systems of healthcare and higher education.
As president and CEO of Philadelphia-based Thomas Jefferson University and Jefferson Health since 2013, he has steered one of the nation’s fastest growing academic health institutions based on his vision of re-imagining health care and higher education. In his five years at the helm, Jefferson has grown from a one university campus-two hospital system to, after regulatory approval of the merger with Einstein health network, a two-university campus-18 hospital system with annual revenues of $6.1 billion and over 35,000 employees.
After this talk, attendees will talk away with:
Moderator:
RaeAnn Grossman, President
Bright Health Plan
Dr. Stephen Klasko, MD, MBA
President and Chief Executive Officer
Thomas Jefferson University and Jefferson Health