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

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

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

Workshop B: Risk Adjustment Professional Advanced Workshop

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

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

Welcome Remarks and Keynote: Lead with Your Best Foot Forward

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

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

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

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

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

Tools & Tech Showcase iconTools & Tech Showcase

Preview Available

Tools & Tech Showcase

Sep 1, 2021 12:05pm ‐ Sep 1, 2021 12:50pm

Leading service providers showcase their offerings in a quick-pitch setting:

  • 12:05PM – 12:20PM MTVatica Health 
  • 12:20PM – 12:35PM MT - Reveleer
  • 12:35PM – 12:50PM MTHealth Fidelity

Track A: What's in the Stars for Star Ratings?

Sep 1, 2021 2:00pm ‐ Sep 1, 2021 2:45pm

  • Discuss new measures and new weights in Star Ratings, with focus on member experience and care transitions
  • Hear various approaches on care plans and different models being implemented by health plans
  • Explore different ways to implement communication requirements


Track B (Virtual): Leading with Digital: How technology is shifting outreach in multi-modal record retrieval

Sep 1, 2021 2:00pm ‐ Sep 1, 2021 2:45pm

  • Learn why digital fulfillment is now the preferred methodology of providers and how payers can support their need
  • Hear what changes in technology are driving the reshuffling of priority including EHR Integrations, interoperability mandates & smarter chase lists
  • Learn the benefits to payer and provider including reduced manhours, quicker access, greater quality & improved security

  • Andy Kumar, Vice President, Product Management – Clinical Data Acquisition & Insights, Ciox Health
  • Amir Keren, Ciox Chief Technology Officer, Ciox Health
  • Deborah Curry, MBA, RHIA, CCS-P, CRC, RAP, AHCCA, Manager, Risk Adjustment, ProMedica

Track C (Virtual): Navigating the Wild West of Digital Clinical Data

Sep 1, 2021 2:00pm ‐ Sep 1, 2021 2:45pm

  • Gain a blueprint for success in leveraging clinical data; including how to identify and connect to data sources such as HIEs and cloud-based EHRs and build a business case to support quality and risk
  • Learn about advances in technology that can be used to normalize, synthesize and enrich these complex data, which are notoriously inconsistent and fragmented
  • Identify the best source of data for your initiatives and learn how to anticipate and mitigate clinical data and quality issues


Track C (Virtual): Continuing the Efforts of Telehealth – Current Successes and Future State

Sep 1, 2021 3:00pm ‐ Sep 1, 2021 3:45pm

  • Hear industry perspectives on the continuing telehealth efforts, tying those into the needs of Quality and Risk Adjustment
  • Hear an update on where Telehealth stands and insights into future state
  • Hear from other health plans on how they are maintaining member engagement through telehealth / telephonic outreach, tips for working with physicians to deliver telehealth
  • Discuss innovative approaches to telehealth efforts