• The essentials of and differences between Medicare Advantage, Commercial and Medicaid risk adjustment
• Understanding how risk scores are calculated
• Making sense of varying payment models
• An intro into using data and predictive analytics to optimize your risk adjustment practices
• Tools for achieving data accuracy
• Where do we stand with the transition from RAPS to EDS? The latest in a long journey
• Provider engagement strategies that will impact your risk adjustment initiatives
• Risk adjustment vendor selection and management
• Determining whether you need RA vendors
• How do you effectively vet potential vendors and ultimately select them?
• Strategies for on-going, thorough vendor management
• The future of risk adjustment – what you need to know to stay ahead of possible changes
• Initial steps for preparing for a RADV audit
• Which staff is essential to overseeing your RADV audit prep?
• Staying ahead – key items to monitor well in advance of an actual audit

The HCC Coding for Accuracy workshop is not just for those directly involved in HCC coding work. It is designed for other disciplines, as well, including finance and analytics professionals. Join us for an introduction to best practices, the opportunity to work through case examples, and to share experiences with your peers. This workshop will zero-in on regulatory compliance while teaching you how to optimize the accuracy of the information gathered and submitted at the practice level. What you will also learn about the way charting is often done, how to overcome “disconnect” with the clinicians and how their typical charting practices and EMRs can create significant problems, and how RADV views documentation in contrast with the way clinicians were taught and EMRs were built initially.
Please note: Attendees are encouraged to bring questions to pose to our expert workshop facilitators and to the table for the group. We provide your workbook which includes copies of the slide deck. You will not need your coding manuals, but most people take notes on their laptop or tablet.

Dialogue, interact and work in small facilitated groups with peers and colleagues

• Understanding the financial overlay – HCC codes mapping to risk adjustment scores
• A single coding and documentation process for Risk adjustment
• Skill development on choosing diagnoses from portions of the encounter – permitted and not permitted
• Clinical documentation barriers for risk adjustment purposes (data validation audit risks)
  

This interactive and informative workshop will explore the following topics through real life case studies and practical takeaways:

• Examples on how to improve outcomes and reduce utilization
• Identify risk adjustment opportunities
• Best practices for addressing quality care gaps
• Discuss which activities can be performed successfully via telemedicine versus face-to-face
• How to leverage technology to meet care delivery expectations
  

Join us for a comprehensive review of 2020 and the changes to Risk Adjustment and Quality that impact your plan. Hear from experts and peers on how each of them navigated the uncharted waters of COVID-19 and how they were able to adapt to the new guidelines and restrictions without sacrificing care. Finally, discover the key to keep up success and improve growth in 2021 and beyond.

• What’s Happened to Risk Adjustment?
• How Have Quality Programs Suffered?
• The Key: EMR Integration and the Future of the Health care Industry

Join CMS representatives as they discuss the Proposed Model Specification Changes in the 2022 Payment Notice, 2021 RA model changes, and RADV Final Rule. They will also address operations update on 2019 and 2020 RADV and EDGE LDS.

The conversation will continue with risk adjustment updates for the Medicare Advantage and Part D programs, reviewing the policies in the 2022 Rate Announcement, including updates to the risk adjustment models, overview of model design, and data used for risk score calculation.