Agenda

With over 30 timely topics and 50+ handpicked speakers, RISE West 2021 featured plenty of content so attendees could walk away with insights and best practices. RISE West 2021 covered the tried-and-true risk adjustment and quality content, plus expanded themes covering member engagement, policy, regulatory updates, and insights into health care investments.

Wednesday - August 31, 2022

4:30 PM 6:00 PM

3:30 PM 5:00 PM

2:30 PM 4:00 PM

1:30 PM 3:00 PM

Exhibit Hall Open

9:00 AM 4:00 PM

8:00 AM 3:00 PM

7:00 AM 2:00 PM

6:00 AM 1:00 PM

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

 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 CPC, CPC-P, CPMA, CPC-I, CRC 
Director, Clinical Documentation Integrity and Coding Compliance 
Capital District Physician's Health Plan (CDPHP)  
 
Donna Malone, CPC, CRC, CRC-I, AHCCA, RAP   
AAPC Approved Instructor  
Director of Ambulatory Clinical Documentation Quality Improvement   
Mount Sinai Health System

 

 

12:00 PM 1:00 PM

11:00 AM 12:00 PM

10:00 AM 11:00 AM

9:00 AM 10:00 AM

Lunch for Workshop Attendees

 

 

1:00 PM 4:00 PM

12:00 PM 3:00 PM

11:00 AM 2:00 PM

10:00 AM 1:00 PM

Workshop B: Risk Adjustment Professional Advanced Workshop 

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   

 

1:00 PM 4:00 PM

12:00 PM 3:00 PM

11:00 AM 2:00 PM

10:00 AM 1:00 PM

Workshop C: Implement Design Thinking into Health Care Initiatives

Design thinking is a human-centered approach to innovation and problem-solving methodology. Various industries are implementing design thinking principles into their product innovation approaches, including health care. 

So, how do you take a big idea and actually execute it?   

In this interactive workshop, attendees: 

  • Learn design thinking principles with a focus on managed care 
  • Hear case examples of how design thinking principles were the basis of innovative approaches to member experience 
  • Identify areas of improvement within your current processes and walk away with a roadmap to product innovation   

Dr. Shannon I. Decker, M.Ed., M.Ed., MBA, MBA, PhD. 
Vice President, Clinical Performance 
Brown & Toland Physicians 

1:00 PM 4:00 PM

12:00 PM 3:00 PM

11:00 AM 2:00 PM

10:00 AM 1:00 PM

Workshop D: Payer / Provider Forum – Opportunities for Alignment, Efficiency and Collaboration    

In light of COVID-19, many aspects of the healthcare sector shifted, including the payer / provider relationship. It’s important, now more than ever, to find better ways of working together as health care workers become more spread thin and provider burden continues to climb.  

Part workshop, part idea exchange session, join this forum and create a call to action within your organization.  

  • Discuss roadblocks in payer / provider collaboration (e.g. data sharing and collection, aligning incentives, etc.)  
  • Assess areas of improvement and support in communication, reporting, and education that can alleviate pressure between the parties 
  • Consider ways that payers have been able to engage providers effectively, with case scenario examples  
  • Discuss new trends in payer / provider contracting and examine win-win scenarios  

Laura Sheriff, RN, MSN, CPC, CRC 
Contracting Risk Adjustment Specialist 

George G Sauers 
Chief Managed Care and Strategy Officer 
Rockport Healthcare Services

Ana Handshuh
Principal
CAT5 Strategies

4:00 PM 6:00 PM

3:00 PM 5:00 PM

2:00 PM 4:00 PM

1:00 PM 3:00 PM

Networking Cocktail Reception

Thursday - September 1, 2022

7:30 AM 8:30 AM

6:30 AM 7:30 AM

5:30 AM 6:30 AM

4:30 AM 5:30 AM

Networking Breakfast

 

7:30 AM 7:30 PM

6:30 AM 6:30 PM

5:30 AM 5:30 PM

4:30 AM 4:30 PM

Exhibit Hall Open

8:30 AM 8:45 AM

7:30 AM 7:45 AM

6:30 AM 6:45 AM

5:30 AM 5:45 AM

Opening Remarks

8:45 AM 9:05 AM

7:45 AM 8:05 AM

6:45 AM 7:05 AM

5:45 AM 6:05 AM

Special Presentation: Music is Medicine

Ryan Brolliar, founder, and author of “The Music is Medicine Tour” inspires us to live life and treat one another in a completely different manner. Ryan’s latest book tells the incredible story of his tour across the entire United States playing music for people in need… 9 months, all 50 states, 78 hospitals, and over 1,500 patients visited!  

RISE welcomes Ryan for a morning dose of inspiration to help us feel connected during a time which we have felt more disconnected than ever before.  

Ryan Brolliar 
Founder and Author 
Music is Medicine Tour 

 

9:05 AM 9:50 AM

8:05 AM 8:50 AM

7:05 AM 7:50 AM

6:05 AM 6:50 AM

Keynote Address: Competing in the New World of Work

At the outset of the pandemic, organizations did more to reengineer work in a few days than over the past 20 years. The changes in structures and behaviors were ruthless and radical—they had to be. Now, after a year of adapting, organizations have settled into new, often better, ways of doing things that will become more permanent and will define how organizations work in the future.  

In this special presentation, gain research-led insights into using radical adaptability to win in a world of unprecedented change. 

Kian Gohar 
Futurist 
Co-author 
WSJ Bestselling Book “Competing in the New World of Work”  
Former Executive Director  
XPRIZE Foundation 
Founder 
GeoLab

 

9:50 AM 10:35 AM

8:50 AM 9:35 AM

7:50 AM 8:35 AM

6:50 AM 7:35 AM

Patient Focus Panel – How Plans and Providers Can Positively Impact Member Experience

Back by popular demand, hear direct feedback from a panel of Medicare & MA customers around their experience, access to care and ways to improve health plan services.   

Moderator: 
Shannon O'Connell 
Engagys 

 

 

10:35 AM 10:55 AM

9:35 AM 9:55 AM

8:35 AM 8:55 AM

7:35 AM 7:55 AM

Networking Break

Concurrent Sessions 10:55 AM - 11:40 AM 9:55 AM - 10:40 AM 8:55 AM - 9:40 AM 7:55 AM - 8:40 AM

10:55 AM 11:40 AM

9:55 AM 10:40 AM

8:55 AM 9:40 AM

7:55 AM 8:40 AM

Gap Identification to Dynamic Interventions: Climbing the Risk Adjustment Analytics Curve to Intelligently Target Members and Achieve Premium Accuracy   

Track A: Risk Adjustment Strategies
  • Learn how your organization’s risk adjustment analytics capabilities compare to your health plan peers according to the latest industry benchmark data  
  • Gain practical steps to implement a more dynamic, analytics-driven approach to prioritizing and prescribing interventions for your plan’s member population  
  • Understand what it means to deconstruct data silos to enable aggregated insights and comprehensive gap closure efforts across risk adjustment and quality (HEDIS/Stars) programs.   

Jonas Foit
Senior Vice President, Analytics and Reporting
Cotiviti, Inc.

Andres Aguirre, MPH
QI Director
Sharp Health Plan

10:55 AM 11:40 AM

9:55 AM 10:40 AM

8:55 AM 9:40 AM

7:55 AM 8:40 AM

Panel: 2022 CMS Star Ratings Changes – Future Impacts and Implications

Track B: Quality
  • Discuss changes that impacted Measurement Year (MY) 2022 and will be coming to the program in MY2023 
  • Examine CMS’ expectations for health plans to utilize digital engagement and activation in CAHPS reporting and care gap closure strategies going forward 
  • Consider CMS’ targeting requirements for rewards and incentives  

 

Moderator:
Daniel Weaver
EVP Product Operations and Stars Strategy
NationsBenefits


Panelists:
Eden Encarnacion, MHA
Director, Quality and Stars Program
Clever Care Health Plan

Ally Thomas, Ph.D. 
AVP, Quality Improvement
UPMC Health Plan

Carmela Costiniuk, MHA
Vice President of Population Health and Clinical Transformation
Catholic Medical Partners

10:55 AM 11:40 AM

9:55 AM 10:40 AM

8:55 AM 9:40 AM

7:55 AM 8:40 AM

Panel: RISE Policy Committee Perspectives on Policy Issues

Track C: Compliance & Regulatory Updates

Back by popular demand, the RISE Policy Committee takes on the most pressing policy issues impacting health plans and risk-bearing providers in the Managed Care, ACA and Commercial Sectors.     

 

Conference attendees will be able to vote on topics to be featured ahead of time.  

 

Potential talking points include: 

  • Deciphering the latest CMS guidance affecting Risk Adjustment and Quality  
  • Transparency and interoperability 
  • Health equity  
  • RADV Audits and how the model will be evaluated going forward   
  • Changes in audits in the ACA space  
  • MA MLR Changes and rebates 

Moderator:
Sean Creighton
Managing Director
Avalere

Panelists:
Michael Adelberg
Practice Leader, Healthcare
Faegre Drinker Consulting

Dave Meyer
RISE Policy Committee Member

Mikal Sutton
Managing Director
Medicaid Policy 
Blue Cross Blue Shield Association

11:40 AM 11:45 AM

10:40 AM 10:45 AM

9:40 AM 9:45 AM

8:40 AM 8:45 AM

Break - transition to concurrent sessions

Concurrent Sessions 11:45 AM - 12:30 PM 10:45 AM - 11:30 AM 9:45 AM - 10:30 AM 8:45 AM - 9:30 AM

11:45 AM 12:30 PM

10:45 AM 11:30 AM

9:45 AM 10:30 AM

8:45 AM 9:30 AM

Panel: The Trifecta Approach to Improving Member Health Outcomes

Track A: Risk Adjustment Strategies
  • Data – discover the key sources of data needed for all three programs 
  • Business operations- learn how to move from a siloed approach to programs to an integrated “next best action” approach. 
  • The multi-year strategy- learn how to design your strategy for success for the long term 

 

Moderator: 
Elaine Taverna 
Senior Vice President, Risk Adjustment and Quality 
Advantasure  

 

Panelists:
Ana Handshuh
Principal
CAT5 Strategies

Gregory Pastor
Managing Director of Risk Adjustment Operations
Advantasure


Additional speakers to be announced

 

11:45 AM 12:30 PM

10:45 AM 11:30 AM

9:45 AM 10:30 AM

8:45 AM 9:30 AM

More Than Test Results: At-home Diagnostics Raise the Score for Quality and Member Satisfaction

Track B: Quality
  • Uncover how innovative technology in the home are serving as a critical and convenient hub for the continuum of care, from annual health evaluations to integrated preventive screening and diagnostic tests that, when coupled with advanced analytics, can detect chronic conditions such as cancer, hypertension, diabetes, and COPD 
  • Learn how at-home lab and diagnostic tools are creating new opportunities for patient-centered care 
  • Hear how health plans can engage at-risk members while driving down avoidable utilization and boosting quality performance safely and effectively 

Marc Rothman, MD 
Chief Medical Officer 
 Signify Health  

Dona Doran 
Program Director Risk Adjustment Operations 
Cambia Health Solutions 

11:45 AM 12:30 PM

10:45 AM 11:30 AM

9:45 AM 10:30 AM

8:45 AM 9:30 AM

Panel: The Current State of RA Litigation and Risk Areas for MA Plans, Vendors and Downstream Entities

Track C: Compliance & Regulatory Updates
  • Examine the current state of risk adjustment litigation and learnings from recent audit activity   
  • Assess risk areas and liability under the false claims act with insights into where the government is pursuing litigation related to chart reviews, physician incentives and home health risk assessments 
  • Gain a better handle on how government entities like the DOJ, OIG and CMS are pursuing or responding to litigation and how to stay on the right side of the line  

Moderator:
Deb Curry, MBA, RHIA, CCS-P, CRC
Director, Risk Adjustment & Recoveries
Actuarial Services
Paramount

Panelists:
Mary Inman
Partner
Constantine Cannon

Ed Baker
Of Counsel
Constantine Cannon

Stephen D. Bittinger
Partner
K&L Gates, LLP

 

12:30 PM 1:30 PM

11:30 AM 12:30 PM

10:30 AM 11:30 AM

9:30 AM 10:30 AM

Networking Lunch

Concurrent Sessions 1:30 AM - 2:15 PM 12:30 AM - 1:15 PM 11:30 PM - 12:15 PM 10:30 PM - 11:15 AM

1:30 AM 2:15 PM

12:30 AM 1:15 PM

11:30 PM 12:15 PM

10:30 PM 11:15 AM

Concurrent Coding – What You Need to Know

Track A: Risk Adjustment Strategies

Susan Waterman RHIT CCS CPC CRC
Director of Risk Adjustment 
Scott and White Health Plan

Laura Sheriff, RN, MSN, CPC, CRC
Contracting Risk Adjustment Specialist

1:30 AM 2:15 PM

12:30 AM 1:15 PM

11:30 PM 12:15 PM

10:30 PM 11:15 AM

Session to be announced

Track B: Quality

1:30 AM 2:15 PM

12:30 AM 1:15 PM

11:30 PM 12:15 PM

10:30 PM 11:15 AM

Session to be announced

Track C: Compliance & Regulatory Updates

Osato F. Chitou
Principal Consultant
NMOC Healthcare Compliance Consulting, LLC, d/b/a Compli by Osato  

2:15 PM 2:20 PM

1:15 PM 1:20 PM

12:15 PM 12:20 PM

11:15 AM 11:20 AM

Break - transition to concurrent sessions

Concurrent Sessions 2:20 PM - 3:05 PM 1:20 PM - 2:05 PM 12:20 PM - 1:05 PM 11:20 AM - 12:05 PM

2:20 PM 3:05 PM

1:20 PM 2:05 PM

12:20 PM 1:05 PM

11:20 AM 12:05 PM

Measure What Matters in Risk Adjustment

Track A: Risk Adjustment Strategies

• Discuss key KPIs and how to measure them
• Understand changes in KPI and their impact on overall program
• Learn how to measure the impact of EMR Integration & NLP

Akash Patel
CEO
Advantmed

Meredith Diep
LA Care

2:20 PM 3:05 PM

1:20 PM 2:05 PM

12:20 PM 1:05 PM

11:20 AM 12:05 PM

Session to be announced

Track B: Quality

Ashley Tyrner
Founder and CEO
FarmboxRx

Lauren Barca, MHA, BSN, RN
Executive Officer, Population Health & Quality
UnitedHealthcare Community Plan of Tennessee

2:20 PM 3:05 PM

1:20 PM 2:05 PM

12:20 PM 1:05 PM

11:20 AM 12:05 PM

Panel: The Checks and Balances of RADV Audits

Track C: Compliance & Regulatory Updates
  • Discuss the checks and balances that health plans should have in place to proactively mitigate submission of unvalidated HCC’s  
  • Hear about juggling audits from multiple entities 
  • Consider best practices in RADV audit preparation

Moderator:
Deb Curry, MBA, RHIA, CCS-P, CRC
Director, Risk Adjustment & Recoveries
Actuarial Services
Paramount

Panelists:
Tom Nasadoski, MBA
Vice President, Risk Adjustment
CDPHP

Wynda Clayton, MS, RHIT Director Risk Adjustment
Providence Health Plan

Susan Waterman RHIT CCS CPC CRC
Director of Risk Adjustment 
Scott and White Health Plan  

 

3:05 AM 3:25 PM

2:05 AM 2:25 PM

1:05 AM 1:25 PM

12:05 AM 12:25 PM

Networking Break

 

 

Concurrent Sessions 3:25 PM - 4:20 PM 2:25 PM - 3:20 PM 1:25 PM - 2:20 PM 12:25 PM - 1:20 PM

3:25 PM 4:20 PM

2:25 PM 3:20 PM

1:25 PM 2:20 PM

12:25 PM 1:20 PM

Panel: Leveraging Point-of-care Diagnostics for Provider Engagement and Telehealth Care Planning

Track A: Risk Adjustment Strategies
  • Utilize multi-modality testing results for care management 
  • Enact care management on members with chronic conditions  
  • Leverage analytics platform to consolidate testing data for RADV audit support  

 

Moderator:
John Romans
CEO
Biomedix

Panelists:
Archita Sood
Chief Medical Officer Homebase Medical

Ryan Dodson
Risk Adjustment Coordinator
Choice Medical Group 

Mark Ishimatsu
Director, Enterprise Risk Adjustment Strategies/Initiatives 
L.A. Care Health Plan

3:25 PM 4:20 PM

2:25 PM 3:20 PM

1:25 PM 2:20 PM

12:25 PM 1:20 PM

Case Study - Creating the Audience of One: Working Together to Revolutionize HEDIS Care Gap Closures and Member Experience

Track B: Quality
  • Examine trends in Stars Quality Improvement and the need to explore new care models to remain relevant among members, and to stay competitive among industry players  
  • Learn how forward-thinking partnerships are creating new innovative strategies that deliver best in class member experience and close HEDIS care gaps  
  • Hear a case study of how Clover Health and Walgreens partnered to meet members where they are to orchestrate better outcomes while hitting HEDIS, HOS, CAHPS and member experience measures   
  • Consider why it is critical to have your HEDIS auditor be a strong partner through the process when the tech specs have not yet caught up to the innovation  

Archana Mahimkar, MS, MBA, CPHQ
Senior Director, Clinical Quality Improvement and Safety
Walgreens Health

Julianne Eckert
Director of Quality Improvement
Clover Health

Katharine Iskrant,
Founder and Practice Lead Healthy People

3:25 PM 4:20 PM

2:25 PM 3:20 PM

1:25 PM 2:20 PM

12:25 PM 1:20 PM

Surfacing High Risk Diagnosis Codes: Leveraging OIG’s Methodology to Better Ensure Integrity in Submissions

Track C: Compliance & Regulatory Updates
  • Discuss the recent literature from the Office of Inspector General focused on integrity in diagnosis code submissions, and impacts on coding in Medicare Advantage   
  • Learn the power of data analysis of medical and pharmacy claims for surfacing problematic diagnoses, and of NLP for evaluating these diagnoses 
  • Understand how to efficiently follow-up on high-risk diagnosis codes in preparation for a potential future audit 
  • Learn what data available in standard claims is key for customizing and expanding the search for high-risk diagnosis codes 

William Schweitzer
Associate, Platform Strategy and Solutions
Episource

Matthew Davis
Assistant Director, Quality Improvement
The Health Plan

4:20 PM 4:25 PM

3:20 PM 3:25 PM

2:20 PM 2:25 PM

1:20 PM 1:25 PM

Break - transition back to General Session

4:25 PM 5:10 PM

3:25 PM 4:10 PM

2:25 PM 3:10 PM

1:25 PM 2:10 PM

Leadership Panel: Learnings from 2022 and Future Outlook

  • Hear leadership perspectives and experiences in managing risk adjustment over the Pandemic and revenue management strategies for the year ahead  
  • Consider what’s on the horizon for Star Ratings and examine the recent changes and their impact on operations   
  • Discuss ways that various departments (e.g. risk adjustment and quality) can find efficiencies and alignment opportunities  
  • Consider the changing state of value-based care & care delivery, including developments in contracting and incentives between payers and providers  

 

Moderator:
Tim Macken
Vice President of Payer Growth
CIOX

Panelists:
Gretchen Shanofsky
Vice President, Plan Operations
Clover Health

Tom Nasadoski, MBA
Vice President, Risk Adjustment
CDPHP

Margaret Paroski, MD
President & Chief Executive Officer
Catholic Medical Partners

 

5:10 PM 5:20 PM

4:10 PM 4:20 PM

3:10 PM 3:20 PM

2:10 PM 2:20 PM

Tools & Technology Spotlight

Leading service providers will showcase their offerings in a quick-pitch setting. Evaluate the latest and greatest tech tools to bring back to your organization.

5:20 PM 5:25 PM

4:20 PM 4:25 PM

3:20 PM 3:25 PM

2:20 PM 2:25 PM

Closing Remarks

5:25 PM 6:25 PM

4:25 PM 5:25 PM

3:25 PM 4:25 PM

2:25 PM 3:25 PM

Interactive Roundtables

Join us for interactive roundtables featuring the latest technologies and solutions for boosting your organization's endeavors. These speed-networking type presentations are 20 minutes long, allowing you to make your way to several roundtables per session. 

6:25 PM 7:30 PM

5:25 PM 6:30 PM

4:25 PM 5:30 PM

3:25 PM 4:30 PM

Networking Cocktail Reception


 

Friday - September 2, 2022

7:45 AM 9:00 AM

6:45 AM 8:00 AM

5:45 AM 7:00 AM

4:45 AM 6:00 AM

Networking Breakfast

7:45 AM 9:00 AM

6:45 AM 8:00 AM

5:45 AM 7:00 AM

4:45 AM 6:00 AM

Special Breakfast and Panel Discussion: Empowering Women in Health Care

  • Hear stories from women succeeding in various sectors of health care (payers, health plans and public health) and what can be done to further the impact of women in the industry  
  • Consider how to promote women in leadership positions across health care and health care adjacent industries  
  • Walk away with tactical takeaways, tips and lessons learned from women who have carved the path the success    

Agenda: 

  • 7:45AM – 8:10AM Breakfast and Networking 
  • 8:10AM – 8:55AM Panel Discussion 
  • 8:55AM – Audience Q&A and Discussion  

Moderator:
Osato F. Chitou
Principal Consultant
NMOC Healthcare Compliance Consulting, LLC, d/b/a Compli by Osato

Panelists:
DeAnna L. Minus-Vincent, MPA
Chief Social Justice & Accountability Officer
RWJBarnabas Health

Tracey Veal, DrPHA, MBA
Senior Advisory Consultant
LA County Public Health Department

Melanie A. Prince, MSN, BSN, RN, NE-BC, CCM, FAAN
Former President
Case Management Society of America
Retired Military Colonel
U.S. Airforce

7:45 AM 1:00 PM

6:45 AM 12:00 PM

5:45 AM 11:00 AM

4:45 AM 10:00 AM

Exhibit Hall Open

9:00 AM 9:05 AM

8:00 AM 8:05 AM

7:00 AM 7:05 AM

6:00 AM 6:05 AM

Opening Remarks

9:05 AM 9:45 AM

8:05 AM 8:45 AM

7:05 AM 7:45 AM

6:05 AM 6:45 AM

Keynote Address: Fireside Chat – Learnings from Grief, Grit and Focusing on The Light at the End of the Tunnel v

 

Moderator: 
To be announced 

 

Interviewee:  

Melanie A. Prince, is the President of Case Management Society of America (CMSA).  She served 30 years in the armed services, retiring in the rank of Colonel assigned to Headquarters Air Force where she was responsible for developing strategies to eliminate interpersonal violence in the military and advanced the Air Force Surgeon General’s global health care strategy. 

 

Join RISE for a special sit-down discussing lessons from her service, from rising to the rank of Colonels to working with Congress, insights from her experience in health care and leadership lessons learned coming out of the other side of COVID-19.  

9:45 AM 9:55 AM

8:45 AM 8:55 AM

7:45 AM 7:55 AM

6:45 AM 6:55 AM

Tools & Technology Spotlight – Presented by Edifecs

Leading service providers will showcase their offerings in a quick-pitch setting. Evaluate the latest and greatest tech tools to bring back to your organization

9:55 AM 10:45 AM

8:55 AM 9:45 AM

7:55 AM 8:45 AM

6:55 AM 7:45 AM

Perspectives Across the Health Care Ecosystem: Steps to Achieving Health Equity and Addressing SDoH for the Aging Population

Join a robust discussion from payers, health care providers and community-based organizations on tactical steps they’ve taken to address health inequities with tactical takeaways for managed care organizations. 

Moderator:
Stick Crosby
Sr Director Provider Network and Health Equity
AllCare Health

Panelists:
DeAnna L. Minus-Vincent, MPA
Chief Social Justice & Accountability Officer
RWJBarnabas Health

Ruth Ann Norton
President and CEO
Green & Healthy Homes Initiative

Rick Whitted
Chief Executive Officer
U.S. Hunger

Priya Radhakrishnan
Chief Academic Officer, VP Health Equity
HonorHealth

10:45 AM 10:55 AM

9:45 AM 9:55 AM

8:45 AM 8:55 AM

7:45 AM 7:55 AM

Tools & Technology Spotlight – Presented by Austin Bostock, Manager, Client Advisory, Pareto Intelligence

Leading service providers will showcase their offerings in a quick-pitch setting. Evaluate the latest and greatest tech tools to bring back to your organization.

10:55 AM 11:15 AM

9:55 AM 10:15 AM

8:55 AM 9:15 AM

7:55 AM 8:15 AM

Networking Break

Concurrent Sessions 11:15 AM - 12:00 PM 10:15 AM - 11:00 AM 9:15 AM - 10:00 AM 8:15 AM - 9:00 AM

11:15 AM 12:00 PM

10:15 AM 11:00 AM

9:15 AM 10:00 AM

8:15 AM 9:00 AM

Stranger Things about Risk Adjustment

Track A: Risk Adjustment Strategies
  • Learn how 3 health plans target providers and members for interventions 
  • Ideas for engaging your providers through transparent alignment strategies and education 
  • Sharing important lessons learned 

 
Jill Strassler 
VP Solutions Management 
Pulse8 

Zoe Benfield 
Director of Risk Adjustment & Medical Economics 
Health Alliance Medical Plan (HAMP) 

Lynn Kryfke 
Executive Director Health Plan Clinical Services 
Children’s Community Health Plan (CCHP)  

 

11:15 AM 12:00 PM

10:15 AM 11:00 AM

9:15 AM 10:00 AM

8:15 AM 9:00 AM

Session to be announced

Track B: The Intersection of RA, Quality & Population Health 

Anand Shah, MD, MS
Vice President of Social Health
Kaiser Permanente

11:15 AM 12:00 PM

10:15 AM 11:00 AM

9:15 AM 10:00 AM

8:15 AM 9:00 AM

Panel: Approaches in Value-Based Contracting Between Payers and Providers

Track C: Payer/Provider Alignment
  • Consider the changing state of value-based care & care delivery, including developments in contracting and incentives between payers and providers  
  • Examine recent changes proposed by CMS in provider incentives and hear what plans are doing to build incentives into contracting in a compliant manner  
  • Discuss case examples of effective contracting between payers / providers 
  • Learn keys in evaluating the success of contracts on an ongoing basis  

Moderator:
Beth Zuehlke
SVP, Customer Success
Moxe Health

Panelists:
Barry Stelmach
CFO
Catholic Medical Partners

George G Sauers
Chief Managed Care and Strategy Officer
Rockport Healthcare Services

Stick Crosby
Sr Director Provider Network and Health Equity
AllCare Health

12:00 PM 1:00 PM

11:00 AM 12:00 PM

10:00 AM 11:00 AM

9:00 AM 10:00 AM

Networking Lunch

Concurrent Sessions 1:00 PM - 1:45 PM 12:00 PM - 12:45 PM 11:00 AM - 11:45 AM 10:00 AM - 10:45 AM

1:00 PM 1:45 PM

12:00 PM 12:45 PM

11:00 AM 11:45 AM

10:00 AM 10:45 AM

Panel: Opportunities for Efficiency and Alignment Between Risk Adjustment & Quality Departments

Track A: Risk Adjustment Strategies
  • Find interdepartmental efficiencies among risk adjustment and quality to make the most of your data, reduce provider outreach, and enhance member experience 
  • Hear case examples of health plans with integrated departments, with highlights of successes 
  • Discuss data management and analytical tools that help centralize and consolidate initiatives  
  • Prospectively identify likely care gaps for both risk adjustment and quality improvement together

Moderator:
Dawn Carter
Director, Product Strategy
Centauri Health Solutions

Panelists:
Amy Smith
Director, Provider Enablement
Sentara Health Plans

Additional speakers to be announced

1:00 PM 1:45 PM

12:00 PM 12:45 PM

11:00 AM 11:45 AM

10:00 AM 10:45 AM

Case Study: Collaboration Beyond COVID-19 - Aligning Quality Metrics with Public Health Goals

Track B: The Intersection of RA, Quality & Population Health
  • Learn about the COVID-19 vaccine journey within Los Angeles County, with insights in what it took to get over 90% of seniors 65+ to receive 2 doses & nearly 70% to get boosted  
  • Gain insights into the collaboration between the public health department, local health systems, community organizations and payers   
  • Discuss the connection to health plan quality metrics and overall immunization efforts  

  

Tracey Veal, DrPHA, MBA  
Senior Advisory Consultant  

LA County Public Health Department 

1:00 PM 1:45 PM

12:00 PM 12:45 PM

11:00 AM 11:45 AM

10:00 AM 10:45 AM

Session held for Apixio

Track C: Payer / Provider Alignment

Pritesh Patel
Director of Strategy
Apixio

Brian Murtha
Centene

1:45 PM 1:50 PM

12:45 PM 12:50 PM

11:45 AM 11:50 AM

10:45 AM 10:50 AM

Break - transition to concurrent sessions

Concurrent Sessions 1:50 PM - 2:35 PM 12:50 PM - 1:35 PM 11:50 AM - 12:35 PM 10:50 AM - 11:35 AM

1:50 PM 2:35 PM

12:50 PM 1:35 PM

11:50 AM 12:35 PM

10:50 AM 11:35 AM

Session to be announced

Track A: Risk Adjustment Strategies

1:50 PM 2:35 PM

12:50 PM 1:35 PM

11:50 AM 12:35 PM

10:50 AM 11:35 AM

Session to be announced

Track B: The Intersection of RA, Quality & Population Health

Ellen Fink-Samnick 
Chair 

RISE SDoH Community

1:50 PM 2:35 PM

12:50 PM 1:35 PM

11:50 AM 12:35 PM

10:50 AM 11:35 AM

Case Study: The Journey to Reduce PCP Burden

Track C: Payer / Provider Alignment
  • Examine the current state of PCP burden, including balancing the burnout vs. patient expansion  
  • Learn about a comprehensive project at Cedars Sinai supporting primary care burnout focused on people, processes and technology 
  • Hear about interim results of several pilots positively impacting primary care physicians and in turn impacting RAF and Quality measures as well as plans to scale those models  

Cynthia Deculus
Chief Population Health Officer
Cedars-Sinai

Lisa Maqueira
Vice President, Revenue Cycle and Managed Care Operations
Cedars-Sinai

2:35 PM 2:40 PM

1:35 PM 1:40 PM

12:35 PM 12:40 PM

11:35 AM 11:40 AM

Break - transition to concurrent sessions

2:40 PM 3:10 PM

1:40 PM 2:10 PM

12:40 PM 1:10 PM

11:40 AM 12:10 PM

Interactive Discussion: The Time is Now - Breaking Down Interorganizational Silos

Join an interactive discussion with the conference chairs on key themes, takeaways, and tactical knowledge to take back to your organization with a focus on ways to coordinate with various departments to: 

  • Find interdepartmental efficiencies    
  • Decrease provider burden, outreach, and abrasion  
  • Be more efficient in sharing data internally to impact risk adjustment, quality and SDoH initiatives

3:10 PM 3:15 PM

2:10 PM 2:15 PM

1:10 PM 1:15 PM

12:10 PM 12:15 PM

Closing Remarks