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Fly-In: 2022 Risk Adjustment

Event Date: 2/8/2022 - 2/9/2022

Event Overview

 

 

Risk adjustment audits, operational best practices, and ACA market competition

 

Join risk adjustment leaders from Alliance member health plans across the country for timely insights into the dramatic increase in DOJ, OIG and CMS activity and the latest code capture best practices. During this one-and-a-half-day meeting, you’ll have valuable time to interface with individuals focused on tackling the same challenges as you. Hear risk adjustment strategy leaders share key takeaways to help your team improve operational efficiency, coding accuracy, compliance, reimbursement accuracy, AND identify cost-savings opportunities.



Top reasons to attend

  1. Hear the latest insights on the recent state and federal cases involving compliance issues and what your team needs to do to avoid legal action from Teresa A. Mason, Epstein, Becker Green, then engage in a lively discussion with Alliance risk adjustment leaders as they share their RADV experience

  2. Unpack recent commercial risk adjustment methodology changes, how some plans achieved a negative error rate and how you can stay ahead of your ACA market competition by differentiating your health plan and targeting the right people for your plan

  3. Explore how Alliance member risk adjustment team dynamics have shifted over the last two years, tips for managing remote teams, and in-sourcing vs. out-sourcing strategies

  4. Discuss how health plans' risk adjustment strategies continue to shift, with new approaches to suspecting, telehealth and deployed devices, and medical record retrieval and storage

  5. Swap provider engagement and incentive program best practices—we'll look at Alliance member incentive program comparison data and discuss what's working

 


Who should attend

Alliance health plan executives and managers with responsibility for:

  • Risk adjustment and HCC coding
  • Provider engagement and education
  • Finance, revenue, and actuarial analysis
  • Government programs


Venue

Magellan Health Studio

Located in Frisco, Texas, Magellan Health Studio focuses on solving healthcare’s most vexing issues through a human-centered design approach that brings innovation to life. Using a proprietary innovation engine, the Studio tests new care delivery models and creates products that address the behavioral health and physical needs of patients. This whole-person approach is powered by deep clinical and digital expertise, advanced analytics, top talent with Fortune 100 healthcare experience, and partnerships with leading innovators who share Magellan Health Studio’s commitment to accelerate the digital capabilities required to address complex healthcare challenges.

 

 

 

 

 


Thank you to our event sponsors


Platinum


Bronze

 

 

COVID Protocols

What to expect: Health and Safety Protocols

The Health Plan Alliance’s hallmark is the unique space we provide for our members and partners to come together and meaningfully connect around the challenges and opportunities your organizations navigate every day. The health and safety of every attendee is our top priority and we are implementing health and safety protocols for our in-person events aimed at protecting all participants. 

These protocols will be updated in response to ongoing guidance from CDC and local health authorities. If you have attended Alliance in-person meetings before, know this experience will be different in many ways – but also rest assured that we remain dedicated to creating unique opportunities to connect, learn and share with your colleagues from across the country.

Please review the Updated Safety protocols HERE

By registering to attend the event you agree and understand these specific risks noted below:

Liability Disclaimer and Release: COVID-19

The novel coronavirus, COVID-19, has been declared a worldwide pandemic.  COVID-19 is reported to be extremely contagious.  The exact methods of spread and contraction are unknown, but the virus is believed to spread from person-to-person, by contact with contaminated objects, and even possibly in the air.  People reportedly can be infected and show no symptoms yet still spread the disease.  COVID-19 is reported to cause serious illness and death. The Health Plan Alliance cannot prevent attendees from becoming exposed to, contracting, or spreading COVID-19 while attending a HPA event or activity.  Any in-person interaction may increase the risk of contracting or spreading COVID-19. 

I agree and understand these specific risks and nonetheless accept them in order to attend this HPA event.  These services are of such value to me that I accept the risk of being exposed to, contracting, and/or spreading COVID-19 in order to participate in person rather than arranging for an alternative method participating or not participating at all.  I further hereby forever release and waive all claims and rights against the Health Plan Alliance in connection with exposure, infection, and/or spread of COVID-19 related to utilizing their services or premises or interacting with their members.  I understand that this release and waiver means I give up my right to bring any claims including for personal injuries, death, disease, property losses, or any other loss that may be released and waived under applicable law, including, but not limited to, claims of negligence, and I understand that this release and waiver prevents me from seeking damages in any way against the Health Plan Alliance, whether such damages are known or unknown, foreseen or unforeseen, or that occur now or in the future. 

I understand that the Health Plan Alliance and the event venue will implement COVID-19 health and safety protocols that align with the most recent guidance released by the CDC and the local health authority.  These protocols will include details regarding code of conduct and safety measures (ie, wearing masks in public spaces, maintaining physical distance during sessions, etc) for all attendees. I understand I will be expected to adhere to these guidelines.

Agenda

Last updated 12/22/2021
(All details in Central Time Zone)

Tuesday, February 8

6:00

Happy Hour and Dinner Mixer


Wednesday, February 9

7:30

Networking Breakfast

8:45

Welcome!

9:00

Fireside Chat: DOJ, OIG, CMS…Oh my! 

10:30

Break

10:45

Commercial Risk Adjustment: Strategies for Reducing Your Transfer Payment Risk 

11:45

Lunch

12:30

Operating in the “new normal” (Closed Door Session)

1:30

Break

1:45

Innovative HCC Capture Tactics

2:45

Provider and Member Engagement and Incentives

3:45

Wrap up and Adjourn


Venue

Meeting Venue

Magellan Health Studio

6303 Cowboys Way
Suite 350
Frisco, TX 75034 

 

Located in Frisco, Texas, Magellan Health Studio focuses on solving healthcare’s most vexing issues through a human-centered design approach that brings innovation to life. Using a proprietary innovation engine, the Studio tests new care delivery models and creates products that address the behavioral health and physical needs of patients. This whole-person approach is powered by deep clinical and digital expertise, advanced analytics, top talent with Fortune 100 healthcare experience, and partnerships with leading innovators who share Magellan Health Studio’s commitment to accelerate the digital capabilities required to address complex healthcare challenges. 

 

 


Hotel Accomodations

Canopy by Hilton Dallas Frisco Station
4455 Frisco Green Ave
Frisco, TX 75034
469.200.6161

 

The hotel room block expires on January 19, 2022
Our room rate is $132 plus taxes/fees. This rate may be available three days prior and three days after our meeting dates, depending on the hotel's availability. You shoul
d call the reservations department at 469.200.6161 and ask for the Health Plan Alliance (Vizient) room rate or click here to book online. Should you call after the deadline, you will not be guaranteed to receive our group room rate or the hotel may be sold out. Please note that the group block could sell out before this date.

 



Additional Info


DRESS
Business casual attire is appropriate for the meeting.  Remember that the hotel meeting room temperatures vary, so we recommend that you layer clothing to be comfortable in case the room becomes either hot or cold.

GROUND TRANSPORTATION
Dallas/Fort Worth International airport is 22 miles away and an estimated fare of $42 Uber/Lyft.  Click here for more details.  

FRISCO WEATHER
View the latest weather forecast.

Documents
2/16/2022

Recording: Fireside Chat: DOJ, OIG, CMS…Oh my!
The government audit and enforcement processes are very interconnected. To avoid legal action, it is critical your health plan is compliant, supervises vendors, audits providers and “looks both ways” when conducting chart reviews. Teresa A Mason, Epstein Becker Green, kick us off with a review of recent state and federal cases involving compliance problems and provide insight into what the OIG is looking for, what the penalties are, and how health plans and providers can avoid legal action. Then, risk adjustment leaders share their RADV experiences in a lively discussion.

2/16/2022

Recording: Commercial Risk Adjustment: Strategies for Reducing Your Transfer Payment Risk
Recent methodology changes resulted in big transfer payments in 2020 due to negative error rates. Together we unpack the methodology changes, how some plans achieved a negative error rate and discuss how you can stay ahead of your ACA market competition by differentiating your health plan and targeting the right people for your plan.

2/16/2022

Recording: Operating in the “new normal”
Team dynamics look a lot different today than they did a year or two ago. We look at how Alliance members have restructured their teams, what everyone’s in-sourcing and out-sourcing strategies look like now and managing remote teams.

2/16/2022

Recording: Innovative HCC Capture Tactics
The pandemic forced us to think creatively about how to capture an accurate picture of our members’ health when they’re no longer going into the doctor’s office. During this session, we hear about how Alliance members’ tactics have shifted through the pandemic and innovative new strategies plans implemented to get an accurate picture of their members’ health.

2/16/2022

Recording: Provider and Member Engagement and Incentives
In this session we discuss how health plans are meeting providers and their staff where they are and the engagement approaches that have been the most successful. We also look at comparison data on the incentives Alliance member health plans are using for both providers and members and discussed what’s working.

2/9/2022

Presentation: Commercial Risk Adjustment - Strategies for Reducing Your Transfer Payment Risk
Recent methodology changes resulted in big transfer payments in 2020 due to negative error rates. Together we unpack the methodology changes, how some plans achieved a negative error rate and how you can stay ahead of your ACA market competition by differentiating your health plan and targeting the right people for your plan.

2/9/2022

Report: Summary Results for Transfer Simulations
Shared at the Risk Adjustment Fly-In, February 8-9, 2022.

2/9/2022

Technical Paper
Shared at the Risk Adjustment Fly-In, February 8-9, 2022.

2/9/2022

Presentation: Innovative HCC Capture Tactics Draccula Overview
The pandemic forced us to think creatively about how to capture an accurate picture of our members' health when they're no longer going into the doctor's office. Hear how Alliance members' tactics have shifted through the pandemic and innovative new strategies plans implemented to get an accurate picture of their members' health.

2/9/2022

Presentation: Provider and Member Engagement and Incentives
Heard how health plans are meeting providers and their staff where they are and the engagement approaches that have been the most successful. Also looked at comparison data on the incentives Alliance member health plans are using for both providers and members and discussed what’s working.

Attendees

Below is a list of all delegates registered to date for this event

  • Joseph Caldwell
  • ALLIANCE MEMBER
  • Chief Financial Officer at Denver Health Medical Plan
  • Jessica Dupont
  • ALLIANCE MEMBER
  • Vice President of Government Programs at Alliant Health Plans
  • Sara Hansen
  • ALLIANCE MEMBER
  • Director of Quality & Clinical Risk Services at Avera Health Plans (DAKOTACARE)
  • Braden Paschall
  • ALLIANCE MEMBER
  • Manager - Data Science and Clinical Insights at IU Health Plans
  • Wesley Sanders
  • ALLIANCE MEMBER
  • Chief Financial Officer at Alliant Health Plans
  • David Seal
  • ALLIANCE MEMBER
  • Executive Director Provider Outreach and Engagement at AdventHealth (FHHS)
  • Paul Sherman
  • ALLIANCE MEMBER
  • Chief Medical Officer at Community Health Plan of Washington
  • Rebecca Stob
  • ALLIANCE MEMBER
  • Director Actuarial and Analytics at Alliant Health Plans
  • Teresa Mason
  • SPEAKER
  • Senior Counsel at Epstein Becker Green (EBG)
  • Brian May
  • SPEAKER
  • Vice President, Customer Engagement at Pulse8
  • Greg Pastor
  • SPEAKER
  • Managing Director - Risk Adjustment at Advantasure
  • Patrick Coulson
  • SPONSOR
  • Chief Growth Officer at Advantasure at Advantasure
  • Jay Scholes
  • SPONSOR
  • Regional Director of Sales at Pulse8
  • Dega Abdi
  • VIRTUAL ATTENDEE - MEMBER
  • Risk Adjustment Coding Auditor at MediGold
  • Kelly Baker
  • VIRTUAL ATTENDEE - MEMBER
  • Supervisor, Risk Adjustment Coding at Presbyterian Health Plan
  • Zoe Benfield
  • VIRTUAL ATTENDEE - MEMBER
  • Director of UM & Risk Adjustment Solutions at Health Alliance Medical Plans
  • Tracy Boback
  • VIRTUAL ATTENDEE - MEMBER
  • Health Risk Coding and Education Specialist II at Health Alliance Plan (HAP)
  • Peter Boss
  • VIRTUAL ATTENDEE - MEMBER
  • Healthcare Data Analyst at Providence Health Plan
  • Terri Bowers
  • VIRTUAL ATTENDEE - MEMBER
  • HCC Risk Adjustment Analyst at Providence Health Plan
  • Jason Brockett
  • VIRTUAL ATTENDEE - MEMBER
  • Sr. Director, Risk Adjustment at Quartz Health Solutions
  • DeeEl Brovetto
  • VIRTUAL ATTENDEE - MEMBER
  • Risk Adjustment Auditor II at Baylor Scott & White Health Plan
  • Susan Budd
  • VIRTUAL ATTENDEE - MEMBER
  • Commercial Products Manager at Denver Health Medical Plan
  • Ngoc Bui-Tong
  • VIRTUAL ATTENDEE - MEMBER
  • Vice President, Strategies and Analytics at Santa Clara Family Health Plan
  • Andrew Bundy
  • VIRTUAL ATTENDEE - MEMBER
  • Manager, Risk Adjustment at Presbyterian Health Plan
  • Jolene Carter
  • VIRTUAL ATTENDEE - MEMBER
  • Certified Medical Review Examiner at CommunityCare
  • Nadine Casey
  • VIRTUAL ATTENDEE - MEMBER
  • Compliance Consultant - Indiana University Health at IU Health Plans
  • Kayleigh Cavano
  • VIRTUAL ATTENDEE - MEMBER
  • Risk Adjustment Coding Auditor at MediGold
  • Jessica Chapagain
  • VIRTUAL ATTENDEE - MEMBER
  • Applications Systems Manager at SelectHealth
  • Aaron Christensen
  • VIRTUAL ATTENDEE - MEMBER
  • Strategic Account Manager at SelectHealth
  • Miriam Clay
  • VIRTUAL ATTENDEE - MEMBER
  • Member Support at Vizient Inc.
  • Wynda Clayton
  • VIRTUAL ATTENDEE - MEMBER
  • Risk Adjustment Manager at Providence Health Plan
  • Brant Coburn
  • VIRTUAL ATTENDEE - MEMBER
  • Senior Data Science Analyst at IU Health Plans
  • Jennifer Cones
  • VIRTUAL ATTENDEE - MEMBER
  • Manager, Outpatient CDI at Henry Ford Health System
  • Deb Curry
  • VIRTUAL ATTENDEE - MEMBER
  • Director Risk Adjustment & Recoveries at Paramount Health Care
  • Esther D'Arezzo
  • VIRTUAL ATTENDEE - MEMBER
  • RN, Lead Clinical Reviewer Risk Adjustment at Neighborhood Health Plan of Rhode Island
  • Nicole Davis
  • VIRTUAL ATTENDEE - MEMBER
  • Risk Adjustment Coder at Baylor Scott & White Health Plan
  • D De Roche
  • VIRTUAL ATTENDEE - MEMBER
  • Manager, Goverment Programs at Community Health Options
  • Alison Dunton
  • VIRTUAL ATTENDEE - MEMBER
  • Director of Practice Enhancement & Analytics at Aspire Health Plan
  • Teya Enerson
  • VIRTUAL ATTENDEE - MEMBER
  • Sr. Claims Coding Associate Pop Health - Risk Adjustment at IU Health Plans
  • Randi Escobedo
  • VIRTUAL ATTENDEE - MEMBER
  • Associate Vice President of Risk Adjustment at Providence Health Plan
  • Matthew Felker
  • VIRTUAL ATTENDEE - MEMBER
  • Director, Actuarial Services Analytics at Quartz Health Solutions
  • Roxanna Geisler
  • VIRTUAL ATTENDEE - MEMBER
  • Medical Coder at IU Health Plans
  • Amber Harris
  • VIRTUAL ATTENDEE - MEMBER
  • Director Risk Adjustment at MediGold
  • Christy Hitchcock
  • VIRTUAL ATTENDEE - MEMBER
  • Risk Adjustment Coding Analyst at CommunityCare
  • James Hiveley
  • VIRTUAL ATTENDEE - MEMBER
  • Vice President, Chief Financial Officer & Treasurer at Quartz Health Solutions
  • Mary Ingram
  • VIRTUAL ATTENDEE - MEMBER
  • Actuarial Services Director at Western Health Advantage
  • Shamyne Jean-Francois
  • VIRTUAL ATTENDEE - MEMBER
  • Risk Adjustment Auditor I at Baylor Scott & White Health Plan
  • Karen Jensen
  • VIRTUAL ATTENDEE - MEMBER
  • Manager, Risk Adjustment and SIU at Quartz Health Solutions
  • Erin Kavanagh
  • VIRTUAL ATTENDEE - MEMBER
  • Risk Adjustment Analyst at Samaritan Health Plans
  • Roth Khea
  • VIRTUAL ATTENDEE - MEMBER
  • Risk Adjustment Coding Specialist at Neighborhood Health Plan of Rhode Island
  • Paul Klatt
  • VIRTUAL ATTENDEE - MEMBER
  • Data Analyst at MediGold
  • Joanne Lauterbach
  • VIRTUAL ATTENDEE - MEMBER
  • Chief Financial Officer at Community Health Options
  • Ed Lee
  • VIRTUAL ATTENDEE - MEMBER
  • Exec Director Healthcare Economics Outcomes at IU Health Plans
  • Brianne Leverenz
  • VIRTUAL ATTENDEE - MEMBER
  • Risk Adjustment Coding Supervisor at Health Alliance Medical Plans
  • Kevin Lewis
  • VIRTUAL ATTENDEE - MEMBER
  • Chief Executive Officer at Community Health Options
  • Viji Malaiyan
  • VIRTUAL ATTENDEE - MEMBER
  • Senior Business Analyst - Sentara Healthcare at Sentara Health Plans (Optima)
  • Meghan Miller
  • VIRTUAL ATTENDEE - MEMBER
  • Risk adjustment auditor at Baylor Scott & White Health Plan
  • Stephne Morgan
  • VIRTUAL ATTENDEE - MEMBER
  • Risk Adjustment Supervisor at Health New England
  • Melissa Morse
  • VIRTUAL ATTENDEE - MEMBER
  • Clinical Program Manager at IU Health Plans
  • Nomsa Mzozoyana
  • VIRTUAL ATTENDEE - MEMBER
  • Project Coordinator at MediGold
  • Kenneth Nagle
  • VIRTUAL ATTENDEE - MEMBER
  • Data Science Analyst at IU Health Plans
  • Cathy Nagy
  • VIRTUAL ATTENDEE - MEMBER
  • Manager, Risk Adjustment Coding and Education at Health Alliance Plan (HAP)
  • Savitha Narayanaraju
  • VIRTUAL ATTENDEE - MEMBER
  • Sr Healthcare Data Analyst at Sentara Health Plans (Optima)
  • Kari Pace
  • VIRTUAL ATTENDEE - MEMBER
  • Clinical Documentation Improvement Nurse-Risk Adjustment/Quality Management at Medical Associates Health Plans
  • Liza Paul
  • VIRTUAL ATTENDEE - MEMBER
  • Vice President of Health Services at MediGold
  • Wade Penner
  • VIRTUAL ATTENDEE - MEMBER
  • Manager Revenue-Risk at Samaritan Health Plans
  • Krystal Revai
  • VIRTUAL ATTENDEE - MEMBER
  • Associate Chief Medical Officer at Health Alliance Medical Plans
  • Monday Reynolds
  • VIRTUAL ATTENDEE - MEMBER
  • CRC at Santa Clara Family Health Plan
  • Ariana Ricci
  • VIRTUAL ATTENDEE - MEMBER
  • Sr. Data Scientist, Risk Adjustment at Neighborhood Health Plan of Rhode Island
  • Celeste Richards
  • VIRTUAL ATTENDEE - MEMBER
  • Chief Operating Officer at Alliant Health Plans
  • Jason Rio
  • VIRTUAL ATTENDEE - MEMBER
  • Sr. Director of Revenue Assurance and Risk Management at Health New England
  • Maria Rodriguez
  • VIRTUAL ATTENDEE - MEMBER
  • Risk Adjustment Coder II at Baylor Scott & White Health Plan
  • Karen Rosen
  • VIRTUAL ATTENDEE - MEMBER
  • Manager, Government Revenue Analytics at Providence Health Plan
  • Mike Sloan
  • VIRTUAL ATTENDEE - MEMBER
  • Manager, Risk Adjustment Submissions & Analytics at MediGold
  • Kathleen Spaulding
  • VIRTUAL ATTENDEE - MEMBER
  • Manager, Risk Adjustment Quality Assurance at Capital District Physicians' Health Plan (CDPHP)
  • ELAINE Taylor
  • VIRTUAL ATTENDEE - MEMBER
  • Compliance Consultant at IU Health Plans
  • Christine Thomas
  • VIRTUAL ATTENDEE - MEMBER
  • Risk Adjustment Coordinator at Samaritan Health Plans
  • Tana Turner
  • VIRTUAL ATTENDEE - MEMBER
  • Risk Adjustment Coding Auditor ll at SelectHealth
  • Muhammad Umar
  • VIRTUAL ATTENDEE - MEMBER
  • Healthcare Data Analyst at Sentara Health Plans (Optima)
  • Diana Vasquez
  • VIRTUAL ATTENDEE - MEMBER
  • Risk Adjustment Coding Specialist at Neighborhood Health Plan of Rhode Island
  • Kayla Walker
  • VIRTUAL ATTENDEE - MEMBER
  • Risk Adjustment Auditor II at Baylor Scott & White Health Plan
  • Josh Weisbrod
  • VIRTUAL ATTENDEE - MEMBER
  • Vice President, Risk Adjustment at Network Health
  • Josh Weisbrod
  • VIRTUAL ATTENDEE - MEMBER
  • VP Risk Adjustment at Network Health
  • Amy Whalen
  • VIRTUAL ATTENDEE - MEMBER
  • Risk Adjustment Coding Specialist at Neighborhood Health Plan of Rhode Island
  • Joan Wilberg
  • VIRTUAL ATTENDEE - MEMBER
  • Manager, Healthcare Economics at IU Health Plans
  • Jennifer Wilson
  • VIRTUAL ATTENDEE - MEMBER
  • Director, Risk Adjustment at Community Health Options
  • Jeremy Wu
  • VIRTUAL ATTENDEE - MEMBER
  • Data Science Analyst at IU Health Plans
  • Margie Zeglen
  • VIRTUAL ATTENDEE - MEMBER
  • Vice President Population Health at Health Alliance Medical Plans
  • Jill Singletary
  • VIRTUAL ATTENDEE - SPONSOR
  • Director Sales, Administrative Services at Advantasure
Speakers