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Aligning Risk Adjustment, Quality and Clinical Informatics Value Visit

Event Date: 6/6/2018 - 6/8/2018

Event Overview

Re-engineering the intersection of people, processes and data to drive better care

Hosted by Mount Carmel Health Plan/MediGold
with Paramount Health Care and SummaCare

Join other risk adjustment, quality, care management and informatics leaders to explore how health plans are re-engineering the way they manage and leverage the data sets critical to clinical decision support and population health efforts.  From informing provider engagement strategies tied to alternative payment models to providing data-driven dashboards and supporting related care management initiatives, leaders in informatics, quality and risk adjustment are collaborating more and more.  While each peer group will benefit from a deep dive into their respective operational areas, most of the meeting is dedicated to exploring where risk adjustment, informatics, care management and quality overlap, and how leaders can support one another’s efforts to better serve our members and empower our provider partners.

 


  

Why you should attend

  1. Dive deep with Alliance member Community Health Plan of Washington on investing in data sharing and alignment with provider partners
  2. Engage in a discussion led by Alliance member Health Alliance Medical Plan on how restructuring people and processes can optimize every time we touch a chart
  3. Learn from a Provider Panel hosted by Alliance member MediGold - what works and what doesn't when it comes to asking for charts and sharing data?  
  4. Hear about how Alliance member Geisinger Health Plan  Used NLP to Boost Risk Adjustment Coding Accuracy and Efficiency 
  5. Collaborate with your colleagues during intimate break out sessions designed to allow peer groups time to dive deep into the topics you care about most
  6. Explore new ways to harness data derived from social determinants of health and stand up a LTSS program with Alliance member Sentara Health

 


Thank you to our event sponsors

 

PLATINUM SPONSORS

 

 

 

 

 

 

 

 

GOLD SPONSORS

 

 

 

 

 

 
 

SILVER PONSORS


 

 

 

 

 
 

 BRONZE SPONSORS

 

 

 

 
 

 

 OTHER SPONSORS

 

 

 

 

 

 

 

 

Agenda

 For a printable, detailed agenda go to the Documents tab above 

 AGENDA AT A GLANCE 

 

Wed, June 6

 

Embracing the strategic imperative – aligning risk, quality and care

7:45 – 8:30am

Breakfast

8:30 – 9:00am

Welcome and Introductions

9:00 – 10:30am

The convergence of the payer and provider worlds and what it means for risk adjustment, quality and care management

10:30 – 10:45am

Break

10:45 – 12:00pm

Session TBD

12:00 – 1:00pm

Lunch

1:00 – 2:30pm

Provider panel discussion on the two sides of the coin: Provider engagement and provider abrasion

2:30 – 3:00pm

Break

3:00 – 4:45pm

Round table break out discussions

6:00pm

Reception

 

Thurs, June 7

 

Using data insights to learn your members’ and providers’ stories – and change them for the better

7:45 – 8:30am

Breakfast

8:30 – 10:15am

Community Health Plan of Washington: Investing in data sharing and alignment with provider partners

10:15 – 10:30am

Break

10:30 – 12:00pm

Leveraging HEDIS measures to identify gaps in your members’ risk scores

12:00 – 1:00 pm

Lunch

1:00 – 2:30pm

Health New England case study: Medical annual wellness visits

2:30 – 3:00pm

Break

3:00 – 4:30pm

Sentara case study on SDOH: LTSS program launch and the power of non-clinical data

6:00pm

Dinner

 

 

Fri, June 8

Operationalizing innovation: Alliance member health plans tackle strategy one initiative at a time

7:45 – 8:30am

Breakfast

8:30 – 10:00am

Geisinger case study: How NLP boosted risk adjustment coding accuracy and efficiency

10:00 – 10:15am

Break

10:15 – 11:30am

Paramount case study: Silo busting between risk adjustment and quality data sets

11:30am

Wrap Up and Adjourn

Venue

Westin in Columbus, OhioThe Westin Columbus Hotel

310 South High Street
Columbus, OH 43215
614.228.3800
Reservations 1-800-Westin-1  (1.800.937.8461)


SOLD OUT:  Room Block Rate $179 plus taxes/fees

The hotel room block expires on May 15, 2018
Our room rate is $179 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 should call the reservations department at 800.937.8461 and ask for the Health Plan Alliance (Vizient Inc) room rate or click here to register on line. 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.

Alternate hotels within 10 minutes of the Westin Columbus

Sheraton Columbus Capitol Square
(0.4 miles), 75 E. State Street, Columbus, OH 43215 (614.365.4500)

Double Tree Suites by Hilton Hotel Columbus Downtown
(0.5 miles), 50 S. Front Street, Columbus, OH  43215  (614.228.4600)

Renaissance Columbus Downtown Hotel

(0.7 miles), 50 N. 3rd Street, Columbus, OH  43215  (614.228.5050)


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
Taxi from the John Glenn Columbus International airport is approximately $25.  Click here for more details.

COLUMBUS CITY WEATHER
View the latest weather forecast.

Documents
6/11/2018

Presentation: Using NLP to boost risk adjustment accuracy and efficiency
Geisinger Health Plan shares strategies for leveraging NLP-Enabled solutions to address risk adjustment challenges and improve productivity and quality.This presentation took place June 2018 at the Risk and Quality event in Columbus OH.

6/11/2018

Presentation: Silo busting between risk adjustment and quality data
Paramount Health's case study describes how their risk adjustment and quality teams are collaborating and aggregating data to improve provider engagement and outcomes.This presentation took place June 2018 at the Risk and Quality event in Columbus OH.

6/11/2018

Presentation: Case Study on Implementing Annual Wellness Visits
Health New England shares a case study on implementing Annual Wellness Visits in conjunction with Baystate Medical Practices, and providing member education and incentive programs. This presentation took place June 2018 at the Risk and Quality event in Columbus OH.

6/11/2018

Presentation: Social Determinants of Health LTSS Program Launch
Sentara (Optima Health) shares an LTSS program launch case study accomplished by applying data aggregation and analytics with an eye on social determinants into their clinical data sets. This presentation took place June 2018 at the Risk and Quality event in Columbus OH.

6/11/2018

UPMC Prescription for Wellness: A Quality Improvement Case Study
This article describes the use of Lean Six Sigma in a quality improvement (QI) effort to design an effective and scalable method for physicians to prescribe health coaching for healthy behaviors in a primary care medical home within a large integrated delivery and financing system.

6/11/2018

Presentation: Investing in data sharing with provider partners
Community Health Plan of Washington shares a case study on how investing in data aggregation, management and analytics providing insights to deliver better care. This presentation took place June 2018 at the Risk and Quality event in Columbus OH.

6/11/2018

Paramount Elite Wellness Visit Incentive brochure 2018
Paramount Health Care shares their member brochure mailing for annual wellness and preventive health services which includes a $50 gift card incentive.

6/11/2018

Risk Adjustment Chart Review Procedure Manual.DOC
Paramount Health Plan shares their procedure for RA chart review. The process is outlined from beginning to end to ensure accurate coding and to understand proper guidelines to ensure documentation of codes submitted for reimbursement.

6/11/2018

Presentation: MediGold Welcome
MediGold share an overview of their organization. This presentation took place June 2018 at the Risk and Quality event in Columbus OH.

6/11/2018

Presentation: Paramount Welcome
Paramount Health Plan shares an overview of their organization. This presentation took place June 2018 at the Risk and Quality event in Columbus OH.

Attendees

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

  • Rick Alexsonshk
  • ALLIANCE MEMBER
  • Director ACA Risk Adjustment at SummaCare
  • Lori Asmus
  • ALLIANCE MEMBER
  • Director, Risk Adjustment at Network Health
  • Julian Bester
  • ALLIANCE MEMBER
  • Program Manager - CHC Technology Services at Community Health Plan of Washington
  • Danielle Brinkley
  • ALLIANCE MEMBER
  • Director, Population Analytics at Community Health Plan of Washington
  • Andrew Bundy
  • ALLIANCE MEMBER
  • Manager, Risk Adjustment at Presbyterian Health Plan
  • Elisha Byrd
  • ALLIANCE MEMBER
  • Hedis Coordinator at MediGold
  • Joe Caldwell
  • ALLIANCE MEMBER
  • Chief Finance Officer at Denver Health Medical Plan
  • Kayleigh Cavano
  • ALLIANCE MEMBER
  • Risk Adjustment Coding Auditor at MediGold
  • Tina Chyko
  • ALLIANCE MEMBER
  • Supervisor - Risk Adjustment at Geisinger Health Plan
  • Andrea Costen
  • ALLIANCE MEMBER
  • Director, Utilization Management, Optima Health Commercial Plans at Sentara Health Plans (Optima)
  • Starlyn Crook
  • ALLIANCE MEMBER
  • Project Manager at HealthTeam Advantage
  • Deb Curry
  • ALLIANCE MEMBER
  • Director Risk Adjustment & Recoveries at Paramount Health Care
  • Jessica Dupont
  • ALLIANCE MEMBER
  • Vice President of Government Programs at Alliant Health Plans
  • Alice Frank
  • ALLIANCE MEMBER
  • Sr Healthcare Informatics Analyst at Quartz Health Solutions
  • Jaime Gonzalez
  • ALLIANCE MEMBER
  • Chief Business Development Officer at Health Plan Alliance
  • Amber Harris
  • ALLIANCE MEMBER
  • Director Risk Adjustment at MediGold
  • Obie Hooper
  • ALLIANCE MEMBER
  • QA Clinical Administrator at Alliant Health Plans
  • Jennifer Hunt
  • ALLIANCE MEMBER
  • AVP Actuarial Services at Paramount Health Care
  • Karen Jensen
  • ALLIANCE MEMBER
  • Manager, Risk Adjustment and SIU at Quartz Health Solutions
  • Paul Klatt
  • ALLIANCE MEMBER
  • Data Analyst at MediGold
  • Shelly Marsh
  • ALLIANCE MEMBER
  • Quality Audit Manager at Physicians Health Plan
  • Cathy Nagy
  • ALLIANCE MEMBER
  • Manager, Risk Adjustment Coding and Education at Health Alliance Plan (HAP)
  • Anita Patel
  • ALLIANCE MEMBER
  • Director, Regional Care Management - Paramount Healthcare at Promedica Health System
  • Liza Paul
  • ALLIANCE MEMBER
  • Vice President of Health Services at MediGold
  • Arthur Robb
  • ALLIANCE MEMBER
  • Director, Strategic Expansion Partnerships at Sentara Health Plans (Optima)
  • Benjamin Rogers
  • ALLIANCE MEMBER
  • Director of Quality, Accreditation & Member Experience at Health New England
  • Melissa Rusk
  • ALLIANCE MEMBER
  • Vice President Operations at SummaCare
  • Mike Sloan
  • ALLIANCE MEMBER
  • Manager, Risk Adjustment Submissions & Analytics at MediGold
  • Angela Thomas
  • ALLIANCE MEMBER
  • Director, Quality & HEDIS at MediGold
  • Geoffrey Todd
  • ALLIANCE MEMBER
  • VP, Value Based Relationships at AvMed
  • Kevin Tolles
  • ALLIANCE MEMBER
  • Manager of Business Analytics and Insights at Paramount Health Care
  • James Troyer
  • ALLIANCE MEMBER
  • Director of Medical Management at Alliant Health Plans
  • Benjamin Vereecke
  • ALLIANCE MEMBER
  • Director - Risk Adjustment & Encounter Data Submissions at Health Alliance Plan (HAP)
  • Joan Wilberg
  • ALLIANCE MEMBER
  • Manager, Healthcare Economics at IU Health Plans
  • Jennifer Yokley
  • ALLIANCE MEMBER
  • Director, Eligibility and Configuration at SummaCare
  • Holly Zorz
  • ALLIANCE MEMBER
  • Quality Improvement Team Lead, Medicare at Paramount Health Care
  • Abdo Abdo
  • SPONSOR
  • Vice President, Business Development at Talix
  • Shahyan Currimbhoy
  • SPONSOR
  • Senior Vice President of Product Management & Engineering at Talix
  • Alexis Levy
  • SPONSOR
  • Managing Director at HealthScape Advisors, LLC
  • Jimmy Liu
  • SPONSOR
  • Vice President, Risk Analytics Services at Optum Advisory
  • Michael Nemeth
  • SPONSOR
  • Director of Revenue Management Strategy at DST Health Solutions
  • Amy Salls
  • SPONSOR
  • Dir, Population Health Strategies at DST Health Solutions
  • Diana Sonbay-Benli
  • SPONSOR
  • Chief Product Officer, TriZetto Healthcare Products Group at Cognizant
  • Kena Hahn
  • VIRTUAL ATTENDEE - MEMBER
  • Director- Medicare Stars and Outpatient Care Coordination at Health Alliance Medical Plans
  • Susan Herbert
  • VIRTUAL ATTENDEE - MEMBER
  • Director, Health Plan Integration & Development at AdventHealth (FHHS)
  • Karen Moncada
  • VIRTUAL ATTENDEE - MEMBER
  • Regulatory Compliance & Accreditation at AvMed
Speakers