RISE West 2021

Aug 30, 2021 ‐ Sep 2, 2021

Standard: $700.00


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

Aug 30, 2021 9:00am ‐ Aug 30, 2021 3:00pm

Identification: MON01

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: Risk Adjustment Professional Advanced Workshop

Aug 30, 2021 10:00am ‐ Aug 30, 2021 1:00pm

Identification: MON02

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

  • 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

Workshop C: Doubling Down on Member Engagement

Aug 31, 2021 1:00pm ‐ Aug 31, 2021 4:00pm

Identification: TUE01

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 so, the big question is, how do you double down on member engagement and 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

  • Sara Hansen, MS, Director of Quality & Clinical Risk Services, Avera Health Plans
  • Ally Thomas, Ph.D., AVP, Quality Improvement, UPMC Health Plan

Workshop D: Success in Risk-Based Arrangements: The Next Frontier of Provider Engagement & Education

Aug 31, 2021 1:00pm ‐ Aug 31, 2021 4:00pm

Identification: TUE02

Now more than ever, it is important for health plans and health care providers to work hand-in-hand to better, more efficient patient care. In this interactive workshop, adult education and provider engagement experts provide guidance and new ideas for health plans looking to better engage their provider partners. Walk away with a mix of tips from the 10,000-foot view as well as operational examples that you can implement into your provider engagement programs.


Pre-Conference Opening Happy Hour

Aug 31, 2021 4:00pm ‐ Aug 31, 2021 5:30pm

Identification: TUE03

In-person attendees will enjoy a socially distanced reception, compliant with CDC guidelines, providing networking opportunities among other in-person attendees, speakers, and solutions providers..

Welcome Remarks and Keynote: Lead with Your Best Foot Forward

Sep 1, 2021 8:45am ‐ Sep 1, 2021 9:45am

Identification: WED001

Welcome Remarks iconWelcome Remarks

Preview Available

Welcome Remarks

Sep 1, 2021 8:45am ‐ Sep 1, 2021 9:00am

Identification: WED01


Keynote: Lead with Your Best Foot Forward – Lessons Learned from the World’s Best Athletes to Achieve Sustained High Performance

Sep 1, 2021 9:00am ‐ Sep 1, 2021 9:45am

Identification: WED02

Join RISE for a special presentation with Dr. Jim Loehr, world-renowned performance psychologist and author of 17 books, sharing insights into 30+ years of proprietary research and training of elite performers, including Olympic gold medalists, military Special Forces, Hostage Rescue teams, surgeons, and Fortune 500 CEOs to achieve sustained high performance.

In this keynote talk, Dr. Loehr focuses on the single most important factor in successful achievement, personal fulfilment, and life satisfaction, with takeaways on how you too can learn these characteristics.

  • Jim Loehr, Ed.D., Co-Founder, Johnson & Johnson Human Performance Institute

Leadership Panel: The Current and Future State in Risk Adjustment and Star Ratings

Sep 1, 2021 10:00am ‐ Sep 1, 2021 10:50am

Identification: WED03

Dissect the impact of deferred care due to COVID-19 and hear ways to mitigate the impact on Risk Adjustment and Quality Programs, Discuss the revenue impact of COVID-19 and hear how health plans are dealing with the effects, Examine new changes in Star Ratings & supplemental benefits and understand how these may affect your programs

  • James Lewis, Former VP of Risk and Quality; Principal Owner, BCBS of Arizona Advantage; Paragon 7ven Studios & Consulting Group
  • Rick Liu, VP, Risk Adjustment, SCAN Health Plan
  • Renée Golderman, Senior Vice President, Chief Quality Officer, CDPHP®
  • Elaine Taverna, Senior Vice President Risk Adjustment and Quality, Advantasure

Panel – The Biden Administration’s Impact on Managed Care: What We’ve Seen So Far and Where We are Headed

Sep 1, 2021 11:05am ‐ Sep 1, 2021 11:50am

Identification: WED04

Experts dissect the Administration's impact on Medicare Advantage, Medicaid and the ACA Marketplace and discuss what's to come, including insights into:
• Fiscal Policy
• Budget and Reconciliation Packages
• Medicaid Expansion
• What's next on the legislative agenda and what's possible on the regulatory side

  • Sean Creighton, Vice President of Federal Policy, Humana
  • Marc Goldwein, Vice President, Risk Adjustment Policy, Committee for a Responsible Federal Budget
  • Mikal Sutton, Senior Vice President and Senior Policy Director, Blue Cross Blue Shield Association
  • David Meyer, Managing Director, Medicaid Policy, RISE Policy Committee
  • Michael Alderberg, Principal, Faegre Drinker Consulting
Print Certificate
Completed on: token-completed_on
Print Transcript
Please select the appropriate credit type:
Number of hours attended:
completed on: 
rendered in: 
* - Indicates answer is required.