Risk Adjustment Value Visit 2017

Event Date: 2/15/2017 - 2/17/2017

Event Overview

2017 Risk Adjustment Value Visit in Orlando, FL

Access the Risk Adjustment Toolkit

Visit the documents tab to access the event podcasts, presentations and shared resources from the Risk Adjustment Value Visit (department org charts, job descriptions and best practices).

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The defining operational and strategic issue for any health plan serving government sponsored beneficiaries is risk adjustment. Join us February 15-17 for a deep dive into documentation, operational, and strategic issues related to risk adjustment.

 

Who should attend?

  • Chief Financial Officers
  • Risk adjustment leaders
  • Clinical analysts and population health stakeholders
  • Government program leaders with responsibility for Medicare Advantage, Medicaid, or the marketplace
  • Certified coders and/or those who manage certified coders


Event highlights

  • EDPS and RAPs reconciliation: How member plans are mitigating risks, managing the process in house, or identifying vendor partners to help them succeed
  • Case Study from Community Health Options (Maine): Translating risk adjustment intel meaningfully into product design
  • Case Study from Health First (Florida): How this plan is capitalizing on its investment in the risk adjustment to extend the program's value

 

Coding Work Group: Live broadcast (in-person and online)

Wednesday, February 15  |  8:30 AM ET  |  90 minutes

A collection of case studies from Alliance member plans, with a focus on appropriate documentation. To join the online broadcast, register for the Value Visit as a virtual attendee and you will receive the dial-in information. (NOTE: CEU earning opportunity*)

 

CEU Earning Opportunities*

This event has been approved for 3.5 CEUs by AAPC and AHIMA.  Individuals who attend the live broadcast of the coding workshop are eligible to earn 1.5 AAPC CEUs and 1.5 AHIMA CEUs for that session and individuals who attend the whole Value Visit in Orlando are eligible to earn 3.5 CEUs from both organizations.

This program has been approved for 3.5 continuing education unit(s) for use in fulfilling the continuing education requirements of the American Health Information Management Association (AHIMA). Granting prior approval from AHIMA does not constitute endorsement of the program content or its program sponsor. 

 

Thank you to our Sponsors

SILVER SPONSORS

 

     

BRONZE SPONSORS

 

 

     

OTHER SPONSORS

                   


 
 
Functions

Wednesday, February 15, 2017

6:30 - 8:30 pm Networking dinner for event delegates at The Rusty Spoon

 

Thursday, February 16, 2017

6:30 - 8:30 pm Networking dinner for event delegates at 310 Lakeside

 
Agenda

AGENDA AT A GLANCE*   (Full agenda can be found in the Documents tab)

*note: this is a working agenda and will be updated as sessions changed a/or speakers are confirmed

**We have been approved for AAPC and AHIMA CEUs 

WED, FEB 15

Documentation, department structure and data management

8:30am

Coding workshop: Case study examples and best practices review (CEU opp)

10:15am

Best practices for a smooth and effective IVA process (CEU opp)

11:15am

RADV: risk mitigation, audit preparation and lessons learned (CEU opp)

12:15pm

Lunch and Learn: Roundtable discussions

1:15pm

Understanding and managing the risks of overpayment

3:15pm

Flash case studies: EDPS and RAPs reconciliation – homegrown solutions

4:15pm

Case study recap: Alliance member plans take RAPID-M for a test drive

THURS, FEB 16

The political environment and strategies for survival

8:30am

Understanding the political environment and the anticipated impact on risk adjustment

10:30am

The fringe impact: How to surf the public exchange risk adjustment wave

1:00pm

Case study: The lifecycle of beginning a new vendor relationship

2:50pm

Case study: Translating risk adjustment intel meaningfully to product design

4:00pm

Case study line up: Working with providers for effective risk adjustment communication and intervention

FRI, FEB 17

Expanding the value prop of risk adjustment

8:00am

Breakfast break outs: Roundtable discussions

8:45am

Department structures and policy and procedure show and tell

9:30am

Case study: An Alliance member health plan capitalizes on their risk adjustment department’s value proposition


 


Venue

Grand Bohemian Hotel in Orlando, FL

Grand Bohemian Hotel
325 S Orange Avenue
Orlando, FL 32801
407.313.9000

Our room rate is $209 plus taxes/fees. Internet access in the guest rooms is complimentary. This rate may be available three days prior and three days after our meeting dates, depending on the hotel's availability. You should call the reservations department at 866-663-0024 and ask for the Health Plan Alliance (HPA) room rate or click here to book your room online. You must call the hotel by January 23, 2017 in order to receive our group room rate. Should you call after this 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.

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
The hotel is about 13 miles from Orlando International Airport (MCO) and is approximately a 25 minute drive. Taxi service is available for an estimated $45 one way.  Valet parking is $26 overnight and $16 if not staying overnight. 

ORLANDO WEATHER
Click here for the latest weather forecast.


Documents

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  • 3/3/2017
  • Audio: The lifecycle of beginning a new vendor relationship
  • This session, presented by Amber Harris, Director Risk Adjustment with MediGold and Pulse8, explores the search, selection and implementation of a new vendor relationship to support an organization's efforts in risk adjustment.
  • 3/3/2017
  • Audio: Understanding the political environment and the anticipated impact on risk adjustment
  • David Smith from Leavitt Partners outlines the hot button issues in the current political environment at three levels: Congressional; the new administration; the state level. After examining what we can expect from these players, David outlines the strategic must-haves he encourages every health plan to consider, to hedge their bets in what is sure to be a volatile marketplace.
  • 2/28/2017
  • Director of Government Program Reimbursement
  • Overall responsibility and accountability for effectively and efficiently leveraging technology and people in delivering a unique and differentiating Member and aligned provider experience through the development and maintenance of coordinated systems, processes and procedures that maximize AvMed's risk-based revenue programs, in a manner that is fully compliant with CMS regulations. The position is responsible for leadership, planning and organization of both the Medicare and ACA revenue optimization functions within AvMed that are charged with maximizing health risk adjusted revenue from CMS. It furthermore supports medical record retrieval process for HEDIS.

Page 2 of 5 First | Previous | Next | Last

Attendees

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

  • Rick Alexsonshk
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Manager Reconciliation Unit at SummaCare
  • Steven Barnett
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Risk Adjustment Operations Supervisor at Health First Health Plans
  • Terri Bowers
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • HCC Risk Adjustment Analyst at Providence Health Plans
  • Laura Breisch
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Director of Gov't Programs and Risk Adjustment at Health First Health Plans
  • Jason Brockett
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Risk Adjustment Analytics Manager at SelectHealth
  • Rachel Burns
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Risk Adjustment Business Analyst at Health First Health Plans
  • Joseph Caldwell
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Chief Financial Officer at Alliant Health Plans
  • Wynda Clayton
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Risk Adjustment Manager at Providence Health Plans
  • Rudy Dominguez
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Population Health Managment Process Specialist at Community Health Plan of Washington
  • Brian Dowdall
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Senior Consultant - Actuarial Services at Sharp Health Plan
  • Chelsea Drake
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Information Analytics Specialist, Senior at Sentara Health Plans (Optima)
  • Jessica Dupont
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Director of Risk Adjustment at Health New England
  • Arthur Greenwood
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Risk Adjustment Manager at Neighborhood Health Plan of Rhode Island
  • Sara Hansen
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Manager of Risk Adjustment Strategy & Operations at Avera Health Plans
  • Amber Harris
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Director Risk Adjustment at Mount Carmel Health Plan
  • Susan Herbert
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Director, Health Plan Integration & Development at Adventist Health System
  • Jennifer Hunt
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Director of Actuarial Services at Paramount Health Care
  • Margaret Hutton
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Coding Analyst at Health Alliance Medical Plans
  • Karen Jensen
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Manager, Risk Adjustment at Quartz Health Solutions
  • Luce Lohier
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Director, Enrollment & Premium Services at AvMed
  • Winston Lonsdale
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • VP, Revenue Management at AvMed
  • Jeretta Mabry
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Manager - Coding Analysis & Education at Health Alliance Medical Plans
  • Daniel O'Connell
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Director, Medical Management at Cox HealthPlans
  • Michelle Peake
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Risk Adjustment Sr Business Analyst at Health First Health Plans
  • Dawn Peterson
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Director, Risk Adjustment Revenue Management at Health Alliance Medical Plans
  • Scott Pistono
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Senior Director, Revenue Management at Health Alliance Plan
  • Rachel Powell
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Director at Health Alliance Plan
  • Kylie Rasmussen
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Risk Adjustment Coding Auditor at SelectHealth
  • Dean Ratzlaff
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Actuary at Sentara Health Plans (Optima)
  • Wesley Sanders
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Director of Finance at Alliant Health Plans
  • Lindsay Schram
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Manager of Risk Adjustment at Health First Health Plans
  • David Seal
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Director of Network Development & Performance at Florida Hospital Healthcare System
  • Alicia Smith
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Manager of Government Programs & Reconciliation at Health First Health Plans
  • Edward Vozzo
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • CFO at Community Health Options
  • April Walters
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Regulatory Relations Specialist at Alliant Health Plans
  • Jennifer Wilson
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Director, Plan Management at Community Health Options
  • Curtis Beharry
  • PLATINUM/GOLD SPONSOR PASS
  • Regional Vice President at Summit Re
  • Dawn Zito
  • PLATINUM/GOLD SPONSOR PASS
  • VP Sales at DST Health Solutions
  • Julia Lambert
  • SPEAKER
  • Principal & Senior Consulting Actuary at Wakely Consulting Group
  • Alexis Levy
  • SPEAKER
  • Director at HealthScape Advisors, LLC
  • Sean Mullin
  • SPEAKER
  • Senior Director at Leavitt Partners, LLC.
  • Alison Pool
  • SPEAKER
  • Sr. Consulting Actuary at Wakely Consulting Group
  • Karan Rustagi
  • SPEAKER
  • Senior Consulting Actuary at Wakely Consulting Group
  • David Smith
  • SPEAKER
  • Chief Development Officer at Leavitt Partners
  • Abdo Abdo
  • SPONSOR
  • Vice President, Business Development at Talix
  • Stacy Duhon
  • SPONSOR
  • Senior Product Manager at Cognizant
  • Becky Erbe
  • SPONSOR
  • VP Government Programs at Cognizant
  • Michael Nemeth
  • SPONSOR
  • Director of Revenue Management Strategy at DST Health Solutions
  • Jay Scholes
  • SPONSOR
  • Sales Executive at Dynamic Healthcare Systems
  • Matt Whitnack
  • SPONSOR
  • Vice President of Sales & Marketing at Dynamic Healthcare Systems
  • Lisa Alexander
  • VIRTUAL ATTENDEE
  • Coding Analyst at Health Alliance Medical Plans
  • Stephne Allen
  • VIRTUAL ATTENDEE
  • Coding Specialist at Health New England
  • Jane Andersen
  • VIRTUAL ATTENDEE
  • Senior Health Economic Specialist at Community Health Options
  • John Baker
  • VIRTUAL ATTENDEE
  • Director of Regulatory Operations & Program Integrity Department at Presbyterian Health Plan
  • Julie Bartels
  • VIRTUAL ATTENDEE
  • Risk Adjustment Analyst at Quartz Health Solutions
  • Robin Bibler
  • VIRTUAL ATTENDEE
  • Risk Adjustment Coding Analyst at Providence Health Plans
  • Sandra Blair
  • VIRTUAL ATTENDEE
  • Supervisor, SIU at Scott & White Health Plan
  • Dalene Brandenburg
  • VIRTUAL ATTENDEE
  • Project Coordinator at Health Alliance Medical Plans
  • Sarah Burke
  • VIRTUAL ATTENDEE
  • Risk Adjustment Auditor at Health First Health Plans
  • Yang Cao
  • VIRTUAL ATTENDEE
  • Actuary at Fidelis Care New York
  • Samantha Caplan
  • VIRTUAL ATTENDEE
  • Risk Adjustment Educator at Providence Health Plans
  • Stefanie Carroll
  • VIRTUAL ATTENDEE
  • Sr. Claims and Reimbursement Specialist at Community Health Plan of Washington
  • Charniece Carter
  • VIRTUAL ATTENDEE
  • Risk Adjustment Analyst at Health First Health Plans
  • Zhuo Chen
  • VIRTUAL ATTENDEE
  • Actuary at Fidelis Care New York
  • Melissa Cook
  • VIRTUAL ATTENDEE
  • President & CEO at Sharp Health Plan
  • Kelli Fisher
  • VIRTUAL ATTENDEE
  • Risk Adjustment Auditor at Paramount Health Care
  • Katherine Ford
  • VIRTUAL ATTENDEE
  • Director, Revenue Management and STARS Operation at Johns Hopkins HealthCare
  • Craig Humphrey
  • VIRTUAL ATTENDEE
  • President at FirstCarolinaCare Insurance Company
  • Amy Jack
  • VIRTUAL ATTENDEE
  • Risk Adjustment Coding Auditor I at SelectHealth
  • Morgan Johnson
  • VIRTUAL ATTENDEE
  • Risk Adjustment Coding Auditor at SelectHealth
  • Erin Kavanagh
  • VIRTUAL ATTENDEE
  • Risk Adjustment Coordinator at Samaritan Health Plans
  • Ariel Kellogg
  • VIRTUAL ATTENDEE
  • Actuarial Analyst at Fidelis Care New York
  • Kaesie Kettinger
  • VIRTUAL ATTENDEE
  • Risk Adjustment Coder at Paramount Health Care
  • Anji Lefler
  • VIRTUAL ATTENDEE
  • Risk Adjustment Coding Auditor at SelectHealth
  • Melissa Lehner
  • VIRTUAL ATTENDEE
  • Director, Business Compliance at Health Alliance Plan
  • Irene Liebenstein
  • VIRTUAL ATTENDEE
  • Manager of Accounting at Physicians Plus Insurance Corporation
  • Rhonda Long
  • VIRTUAL ATTENDEE
  • Coding Analyst at Health Alliance Medical Plans
  • Michael Lorhan
  • VIRTUAL ATTENDEE
  • Interim VP of Finance at Physicians Plus Insurance Corporation
  • Jaylene Olson
  • VIRTUAL ATTENDEE
  • Coding Analyst at Health Alliance Medical Plans
  • Kari Pace
  • VIRTUAL ATTENDEE
  • Quality Improvement/Risk Adjustment Nurse at Medical Associates Health Plans
  • Lauren Reynolds
  • VIRTUAL ATTENDEE
  • Risk Adjustment Coding Auditor at SelectHealth
  • Doris Rich
  • VIRTUAL ATTENDEE
  • Coding Analyst at Health Alliance Medical Plans
  • Jennifer Rohs
  • VIRTUAL ATTENDEE
  • Manager, Documentation and Coding Education at Henry Ford Health System
  • Katherine Ross
  • VIRTUAL ATTENDEE
  • Risk Reconciliation Specialist at Paramount Health Care
  • Kristy Russell
  • VIRTUAL ATTENDEE
  • Risk Adjustment Coding Auditor at SelectHealth
  • Tana Turner
  • VIRTUAL ATTENDEE
  • Risk Adjustment Coding Auditor at SelectHealth
  • Erin Walsh
  • VIRTUAL ATTENDEE
  • Marketplace Delivery System Administrator at Indiana University Health Plans
  • Joan Wilberg
  • VIRTUAL ATTENDEE
  • Manager, Healthcare Economics at Indiana University Health Plans
  • Colin Yi
  • VIRTUAL ATTENDEE
  • Actuary Analyst at Fidelis Care New York
Speakers