RISE West 2020

Sep 9, 2020 ‐ Sep 11, 2020

Standard: $700.00


Workshop A: HCC Coding 201 – Leading and Implementing HCC Coding and Documentation Programs

Sep 9, 2020 12:00pm ‐ Sep 9, 2020 6:00pm

Identification: WED01

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:
• Achieve plan -level program process, collaboration and continuous Improvement
• Create a framework for provider office-based program and learn how to roll this out
• Review clinical documentation evaluation in current systems
• Get a handle on program development and implementation: creating compliant & quality coding

  • Colleen Gianatasio, Devoted Health
  • Donna Malone, CPC, CRC, CRC-I, AHCCA, RAP, AAPC Approved InstructorDirector of Ambulatory Clinical Documentation Quality Improvement, Mount Sinai Health System

Workshop B: Doubling Down on Member Engagement

Sep 9, 2020 1:00pm ‐ Sep 9, 2020 4:00pm

Identification: WED02

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:
- Keep up with the changing quality guidelines for health plans, including the change of CAHPs survey scores to four way
- Implement CAHPS improvement strategies and customer service operations to optimize member experience
- Assess the member experience with telehealth and understand the implications moving forward
- Plan for a second wave of COVID-19 and strategies to close gaps in the meantime


Workshop C: Risk Adjustment Professional Advanced Workshop

Sep 9, 2020 1:00pm ‐ Sep 9, 2020 4:00pm

Identification: WED03

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:
• Gain the tools to navigate reporting and review, achieve data accuracy and manage the transition from RAPS to EDPS
• Discuss managing within the organization, including what should be reported to senior management and when
• How to manage vendors effectively – including make or buy decisions and collaboration techniques
• Leverage your coding & documentation team’s capabilities and your analytics tools
• Keep a finger on the pulse of the expected revenue volume and timing of cash flow realization
• Learn how to be prepared for future changes within the risk adjustment landscape

  • Susan Waterman, RHIT, CCS, CPC, CRC, Director of Risk Adjustment, Scott and White Health Plan
  • Deborah Curry, MBA, RHIA, CCS-P, CRC, RAP, AHCCA, Manager, Risk Adjustment, ProMedica

Opening Remarks & Keynote: Leading During Times of Crisis

Sep 10, 2020 10:00am ‐ Sep 10, 2020 11:00am

Identification: THU_01

Opening Remarks iconOpening Remarks

Preview Available

Opening Remarks

Sep 10, 2020 10:00am ‐ Sep 10, 2020 10:10am

Identification: THU01


Keynote: Leading During Times of Crisis

Sep 10, 2020 10:10am ‐ Sep 10, 2020 11:00am

Identification: THU02

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

Predictions on the 2020 Election Results: The Effect on Medicare, Medicare Advantage and the ACA

Sep 10, 2020 11:10am ‐ Sep 10, 2020 12:00pm

Identification: THU03

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:
- The effect of COVID-19 on the landscape as it relates to healthcare policy (i.e. Medicaid waivers, the impact of unemployment and Medicaid Expansion, etc.)
- The long-term view of the damage done to the healthcare infrastructure and future healthcare policy
- The landscape for pandemic preparedness and the national vs. states’ roles in policy and readiness

  • John E. McDonough, DrPH, MPA, Professor of Public Health Practice, Harvard T.H. Chan School of Public Health

Payer Perspective Panel: Catching Up on the Shortened Calendar Year

Sep 10, 2020 12:10pm ‐ Sep 10, 2020 1:00pm

Identification: THU04

• Dealing with the revenue shortfall: what the pandemic means for 2021 risk & quality scores
• Discuss how the absence of that documentation (because of COVID-related seclusions) could adversely impact risk adjustment (HCC) for next year and beyond – and strategies to combat this
• Hear perspectives from health plans on how they are catching up on the 5-Star Quality Program

  • Mark Dodge, Assistant Vice President, Stars Program, Bright Health Plan
  • Tom Lutzow, President and CEO, Independent Care Health Plan
  • Jason McDaniel, Vice President, Risk Adjustment & Quality, Intermountain Healthcare, Nevada
  • Sean Creighton, Vice President of Federal Policy, Humana

4 Strategies to Prepare for 4x CAHPS Weighting

Sep 10, 2020 1:00pm ‐ Sep 10, 2020 2:00pm

Identification: THURT5

Improve Risk Revenue with Electronic Data Retrieval and NLP

Sep 10, 2020 1:00pm ‐ Sep 10, 2020 2:00pm

Identification: THURT6

The world as we know it has shifted and business strategies are evolving with it. During this roundtable, we’ll discuss risk adjustment in consideration of the pandemic. Chad will share how Change Healthcare has modernized our retrieval and coding operations to meet the needs of our clients. Join the conversation to discuss new ways your organization can achieve better risk adjustment results. Attendees will learn: 

• New innovations in chart retrieval to connect and retrieve clinical data directly from claim partners and EHR systems 

• How electronic retrieval will improve the time to retrieve charts, increase chase yields, and reduce the administrative burden on provider offices 

• The benefits NLP-enabled coding has had on our customers to improve efficiency, increase coding accuracy, mitigate RADV Risk, and increase ROI