CMS Risk Adjustment – Key Tactics for 2021

Mar 29, 2021 11:15am ‐ Mar 29, 2021 12:00pm

Identification: MON05

  • Discuss the changing landscape of CMS Risk Adjustment impacting 2021 and on
  • Explore the role of vendors within the current mix of industry approaches
  • Learn which the best practices are emerging, and which old approaches are going away
  • Coding, NLP, Telehealth and In-homes…sure, but what’s next…?

How Advanced Technologies & Data Analytics Platforms are Driving More Value in Today’s Value-Based Care Arrangements

Mar 29, 2021 11:15am ‐ Mar 29, 2021 12:00pm

Identification: MON06

  • Deep dive into the evolving value-based care and contracting landscape
  • Common challenges experienced by payers and providers in value-based care arrangements
  • Best practices leveraging technology and data analytics platforms to effectively implement successful value-based contracts
  • Key considerations for determining the right value-based care technology strategy for your organization

Integrating Health Management with Risk Adjustment and Quality

Mar 29, 2021 11:15am ‐ Mar 29, 2021 12:00pm

Identification: MON07

  • Understand the benefits of incorporating your Risk Adjustment and Quality initiatives into a Health Management workflow
  • Learn about the increasing challenges of health care delivery requirements and how you can leverage your data into relevant and actionable intelligence
  • Hear about practical examples and insights for success in harmonizing data and integrating workflows

Connecting the Dots: Transforming Social Determinants of Health Data into Big Picture Results

Mar 29, 2021 11:15am ‐ Mar 29, 2021 12:00pm

Identification: MON08

  • Capturing and utilizing available information to improve whole-person care
  • Collaborating with stakeholders and community-based organizations to close gaps
  • Enhancing care without overburdening providers or encroaching on patients’ privacy or trust

Using SDOH to Improve Member Engagement, Stars and Quality Performance: A Health Plan Case Study

Mar 29, 2021 11:15am ‐ Mar 29, 2021 12:00pm

Identification: MON09

Understanding member needs and building a holistic strategy that leverages SDoH to gather member insight can help drive better results. Join our session to:

  • Learn about a strategy that leverages SDoH to identify and support at-risk populations, aiming to address social barriers that can positively impact Stars, HEDIS, and other performance measures.
  • Discuss how payers are building on initial success to manage and increase retention, boost NPS scores, and improve other key metrics.
  • Consider the evolving application of SDoH from supporting and influencing social infrastructure, to applying behavioral science insights to help inform communications that facilitate better engagement.



CAPs, Gaps, and Maps: The Effective Use of CMS Reporting as A Compass to Optimize Risk Adjustment Strategy

Mar 29, 2021 1:00pm ‐ Mar 29, 2021 1:45pm

Identification: MON10

  • A summary of EDPS reports and their content and how they identify foundational gaps in data submission strategies, which is especially important as we have arrived at the intersection of risk adjustment and quality
  • How to proactively focus EDPS and RAPS data submission strategies around these reports as the compass for a roadmap that lays a foundation for operational and financial success rather than treating reporting as an afterthought
  • How to avoid having to submit corrective action plans (CAPs) or get caught in “analysis paralysis”, and how to submit thoughtful action plans if required to do so
  • How a health plan has successfully leveraged their people, processes and technology for the development of a successful reporting strategy that informs their overall organizational risk adjustment strategy and serves as the compass for their best practices roadmap

Managing the Risk in Risk Adjustment – How Using Your Data Can Improve Care Management and Overall Outcomes

Mar 29, 2021 1:00pm ‐ Mar 29, 2021 1:45pm

Identification: MON11

  • Use of internal and CMS data files in analytics, outreach and forecasting (thoughts on Payor vs Provider perspectives)
  • Integrating internal analyses with third party vendors and platforms
  • Discussion of industry best practices and integration of appropriate controls to minimize compliance risk

Performance Management: Developing KPIs for your Prospective Program

Mar 29, 2021 1:00pm ‐ Mar 29, 2021 1:45pm

Identification: MON12

  • Minimizing challenges and exploiting opportunities to develop KPIs and implement processes for your prospective solution
  • Determining what a new diagnosis looks like and how to proceed with this diagnosis in alignment with your KPI
  • Develop 360 KPIs to measure the success of your prospective program

How to Achieve True Member Centricity

Mar 29, 2021 1:00pm ‐ Mar 29, 2021 1:45pm

Identification: MON13

In this session, you will gain a deep understanding of how to achieve true member centricity and strategies you can apply including:

  • Learn techniques to break down barriers with a more personalized member experience
  • Define care model to identify the unique social and clinical care needs of each member and address those needs
  • Discuss the fundamental framework to empower your members to increase healthy, happy days at home

National Committee for Quality Assurance (NCQA) Update

Mar 29, 2021 1:00pm ‐ Mar 29, 2021 1:45pm

Identification: MON14

Join this fireside chat to discuss NCQA’s recommendations to the new administration including efforts towards health equity and addressing social determinants of health, as well as moving to a digital quality measure system to improve data and lessen burden. They will also address questions regarding the launch of the Data Aggregator Validation program, its benefits, and what to expect in the upcoming months.