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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

Page 1 of 2 Next | Last

  • 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
  • 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.

Page 1 of 2 Next | Last

Attendees

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

  • Stephen Adamson
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • COO at SummaCare
  • Richard Alexsonshk
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Director Risk Adjustment at SummaCare
  • Lori Asmus
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Director, Risk Adjustment at Network Health Plan
  • Gay Ball
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • MRA Program Manager at Cone Health
  • Matt Barrett
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Vice President, Network Management at Mount Carmel Health Plan (MediGold)
  • Kim Barrus
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Medical Home Manager at SelectHealth
  • Jamie Benedict
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Chief Strategic Growth Officer at Mount Carmel Health Plan (MediGold)
  • Barbara Berger
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • VP Care Management Services at FirstCare Health Plans
  • Julian Bester
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Program Manager - CHC Technology Services at Community Health Plan of Washington
  • Stacey Bock
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • VP of Finance at Paramount Health Care
  • Brandon Bock
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Quality Improvement Documentation Coordinator at Paramount Health Care
  • Kathy Bockhop
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Sr Healthcare Informatics Analyst at Quartz Health Solutions
  • Karen Bray
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • VP, Clinical Care Services at Sentara Health Plans (Optima)
  • Danielle Brinkley
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Manager, Population Analytics at Community Health Plan of Washington
  • Jason Brockett
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Risk Adjustment Analytics Manager at SelectHealth
  • Andrew Bundy
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Manager, Risk Adjustment at Presbyterian Health Plan
  • Elisha Byrd
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Hedis Coordinator at Mount Carmel Health Plan (MediGold)
  • Jennifer Cady
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • QI/HEDIS Analyst II at Paramount Health Care
  • Joseph Caldwell
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Chief Financial Officer at Alliant Health Plans
  • Kayleigh Cavano
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Risk Adjustment Coding Auditor at Mount Carmel Health Plan (MediGold)
  • Tina Chyko
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • GHP Coder III at Geisinger Health Plan
  • Andrea Costen
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Director, Utilization Management, Optima Health Community Care at Sentara Health Plans (Optima)
  • Carrie Cramer
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Analyst at Paramount Health Care
  • starlyn crook
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • risk manager at HealthTeam Advantage
  • Deb Curry
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Risk Adjustment Manager at Paramount Health Care
  • Sara Curry
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Risk Adjustment Coder III at Geisinger Health Plan
  • Brad Davis
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Provider Relations Network Manager at Mount Carmel Health Plan (MediGold)
  • Michael Demand
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • President and CEO at Mount Carmel Health Plan (MediGold)
  • Linda Dickinson
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Quality Management Director at Physicians Health Plan
  • Jessica Dupont
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Director of Risk Adjustment at Health New England
  • Morris Ellington
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Provider Relations & Network Manager at Mount Carmel Health Plan (MediGold)
  • David Engleking
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Medical Director at CHRISTUS Health Plan
  • Howard Epstein
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • SVP & CMO at PreferredOne
  • Kelli Fisher
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Risk Adjustment Auditor at Paramount Health Care
  • Alice Frank
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Sr Healthcare Informatics Analyst at Quartz Health Solutions
  • Stacey Friedman
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Director, Quality & HEDIS at Mount Carmel Health Plan (MediGold)
  • Nancy Gardner
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • HEDIS Project Coordinator at Mount Carmel Health Plan (MediGold)
  • Stacy Garguilo
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Hedis Coordinator at Mount Carmel Health Plan (MediGold)
  • Jaime Gonzalez
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Chief Business Development Officer at Health Plan Alliance
  • Sarah Gunderson
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Health Informatics Analyst at FirstCare Health Plans
  • Amber Harris
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Director Risk Adjustment at Mount Carmel Health Plan (MediGold)
  • Obie Hooper
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Quality Assurance Clinical Coordinator at Alliant Health Plans
  • Jennifer Hunt
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Director of Actuarial Services at Paramount Health Care
  • Allison Hurlock
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Dir. of Med. Mgt at CHRISTUS Health Plan
  • Chamese Jarrett
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Auditor at Mount Carmel Health Plan (MediGold)
  • Karen Jensen
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Manager, Risk Adjustment at Quartz Health Solutions
  • Lisa Johnston
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Quality Assurance Coordinator at Alliant Health Plans
  • Paul Klatt
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Data Analyst at Mount Carmel Health Plan (MediGold)
  • Gina Kokinda
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • HEDIS Coordinator at Mount Carmel Health Plan (MediGold)
  • Brenda Langenderfer
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Senior QI/HEDIS Analyst at Paramount Health Care
  • David Larsen
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Director, Quality Improvement at SelectHealth
  • Rhonda Maddern
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Director, Utilization Management at Mount Carmel Health Plan (MediGold)
  • Shelly Marsh
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • HEDIS Supervisor at Physicians Health Plan
  • John Meier
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • VP, Medical Director at Paramount Health Care
  • Mary Miller
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • VP, Integrated Healthcare Services at PreferredOne
  • Nicolle Mustafa
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Director Quality Management at CHRISTUS Health Plan
  • Cathy Nagy
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Manager, Risk Adjustment Coding and Education at Health Alliance Plan
  • Andrew Ngo
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Analyst at Paramount Health Care
  • Anita Patel
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Director, Regional Care Management - Paramount at Promedica Health System
  • Liza Paul
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Director of Case Management at Mount Carmel Health Plan (MediGold)
  • Dawn Peterson
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Director of Utilization Management and Risk Adjustment Solutions at Health Alliance Medical Plans
  • Larry Pliskin
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • VP, Compliance and Governance at Mount Carmel Health Plan (MediGold)
  • Arthur Robb
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Director, Strategic Expansion Partnerships at Sentara Health Plans (Optima)
  • Benjamin Rogers
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Lead Healthcare Informatics Analyst at Health New England
  • Melissa Rusk
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Director, Claims and BPO Operations at SummaCare
  • Annie Shmookler
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Medical Data Analyst at Mount Carmel Health Plan (MediGold)
  • Mike Sloan
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Risk Adjustment Reconciliation Analyst at Mount Carmel Health Plan (MediGold)
  • Elaine Taverna
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Vice President Revenue Management and Risk Adjustment at Health Alliance Plan
  • Angela Thomas
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Manager, Quality & HEDIS at Mount Carmel Health Plan (MediGold)
  • Geoffrey Todd
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Director, Healthcare Economics and Collaborative Care Networks at AvMed
  • Kevin Tolles
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Risk Adjustment Analyst at Paramount Health Care
  • James Troyer
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Director of Medical Management at Alliant Health Plans
  • Benjamin Vereecke
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Manager - Risk Adjustment Programs & Operations at Health Alliance Plan
  • Edward Vozzo
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • CFO at Community Health Options
  • Joan Wilberg
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Manager, Healthcare Economics at Indiana University Health Plans
  • John Wiley
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Vice President Network Management at Health Alliance Plan
  • Jennifer Yokley
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Director, Eligibility and Configuration at SummaCare
  • Holly Zorz
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Quality Improvement Project Coordinator III at Paramount Health Care
  • David Beck
  • PLATINUM/GOLD SPONSOR PASS
  • Venture Leader at Cognizant
  • Tony Glebe
  • SPEAKER
  • VP Strategic Partnerships at Medecision
  • Derek Woo
  • SPEAKER
  • Senior Vice President, Decision Analytics at Change Healthcare Consulting
  • Abdo Abdo
  • SPONSOR
  • Vice President, Business Development at Talix
  • Diana Benli
  • SPONSOR
  • VP Government Payer Solutions at Cognizant
  • Shahyan Currimbhoy
  • SPONSOR
  • Senior Vice President of Product Management & Engineering at Talix
  • David Gallegos
  • SPONSOR
  • SVP Consulting Services at Change Healthcare Consulting
  • Alexis Levy
  • SPONSOR
  • Managing Director at HealthScape Advisors, LLC
  • Jimmy Liu
  • SPONSOR
  • Vice President, Risk Analytics Services at Change Healthcare Consulting
  • Michael Nemeth
  • SPONSOR
  • Director of Revenue Management Strategy at DST Health Solutions
  • Amy Salls
  • SPONSOR
  • Dir, Population Health Strategies at DST Health Solutions
  • Jay Scholes
  • SPONSOR
  • Sales Executive at Dynamic Healthcare Systems
  • Chris Simmons
  • SPONSOR
  • Vice President, Clinical Analytics at Pulse8
  • Dan Skari
  • SPONSOR
  • AVP at MedeAnalytics, Inc
  • Michael Stedman
  • SPONSOR
  • Senior Sales Executive at Performance Clinical Systems
  • Olamide Akanbi
  • VIRTUAL ATTENDEE
  • Medicare Compliance Coordinator at Paramount Health Care
  • Terrie Anello
  • VIRTUAL ATTENDEE
  • Quality Improvement Coordinator at Paramount Health Care
  • Bernice Bonner
  • VIRTUAL ATTENDEE
  • Program Development Lead at Health Alliance Plan
  • Dorothy Fisher
  • VIRTUAL ATTENDEE
  • Medical Director at Geisinger Health Plan
  • Kena Hahn
  • VIRTUAL ATTENDEE
  • Director- Health Coaching, Consultative Services and Star Ratings at Health Alliance Medical Plans
  • Susan Herbert
  • VIRTUAL ATTENDEE
  • Director, Health Plan Integration & Development at Adventist Health System (FHHS)
  • Karen Moncada
  • VIRTUAL ATTENDEE
  • Regulatory Compliance & Accreditation at AvMed
  • Wesley Sanders
  • VIRTUAL ATTENDEE
  • Director of Finance at Alliant Health Plans
Speakers