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Risk Adjustment Master Class 2020

Event Date: 2/4/2020 - 2/5/2020

Event Overview


  

Risk adjustment (RA) leaders from Alliance member health plans across the country convene for this concentrated workshop and master class.  The event features seven highly focused sessions that dive deep into the strategy and tactics of successful RA programs, each showcasing faculty members led by your Alliance colleagues. If you've attended a fly-in before, prepare yourself for a completely re-imagined format. Attendees will be working elbow to elbow with their Alliance colleagues, sharing out discreet pre-work, and collecting specific, actionable insight from your fellow RA leaders.

 


 

Top reasons to attend

The event kicks off with a members-exclusive, closed session. We'll use this time behind closed door to have candid conversations about:

  • How Alliance member health plans approach RA staffing and organizational structure.
    Size, complexity, org. structure, and your provider partners' risk appetite are just some factors that impact your staffing structure, department model and policies. 

  • The pains and gains of outsourcing vs. insourcing risk adjustment functions. 
    What processes do other RA leaders rely on vendors to complete? Which Alliance plans are die-hard DIYers? Are there specific areas your RA department is hoping to improve via an outsourced or internally developed approach? The session facilitates a “show and tell” approach between Alliance members.

  • Best practices in vendor management: Lessons learned and winning approaches from RA leaders.
    In this flash case study and discussion session, Alliance members share the best approach to oversee and manage vendors.

 

This member-exclusive, closed session provides a thoughtfully designed space that makes connecting with your peers easy.  And it's just the kick off for day two of the workshop! Check out the Agenda and Documents tabs above to view full event details.  

 



A few other things we're excited about ...

  • After the members-only session, we're hosting a private reception, strolling dinner and vendor showcase. It's a relaxed evening with your Alliance colleagues and the event sponsors where you can learn more about your Alliance network and the solutions recommended by your Alliance colleagues.

  • Alliance members benefit from a room block at the Aloft hotel—just down the street from the learning center. It means you can keep the conversations going after hours and enjoy the common spaces in the comfortable Aloft lounge. 




Who should attend

This meeting is limited to Health Plan Alliance members and invited guests and is designed for risk adjustment leaders and their teams, with particular emphasis on the ACA and MA product lines.


Alliance member health system and/or provider groups are also invited attend.



 

Thank you to our event sponsors


Silver


Bronze

 


 

Thank you to our event sponsors


Silver


Bronze

 



 

Thank you to our event sponsors


Silver


Bronze

 


Agenda

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

AGENDA AT A GLANCE (updated November 12, 2019)

 

TUES, FEB 4  Alliance Member-Only Sessions

1:00 

Alliance member plan attendees check in and badge pick up 

1:20

Welcome!

1:45

Show and tell: How Alliance member health plans approach risk adjustment staffing and organizational structure

2:45

Who does what? Alliance members discuss pains and gains of outsourcing vs. insourcing risk adjustment functions

3:45

Break

4:15

Best practices in vendor management: Lessons learned and winning approaches from risk adjustment leaders

4:30

Vendor fair participants check in, badge pick up, and table set up

6:00

Networking reception and strolling dinner at the Vendor Fair

WED, FEB 5 Open to all registrants

7:00

Breakfast: hosted at the Aloft hotel

8:30

Welcome back!

8:45

Preparing for risk adjustment audits: MA and ACA

9:45

Break

10:00

Revenue projections are hard. Why your RAF isn’t what you expect – and what your Alliance colleagues are doing about it

11:30

Lunch

12:30

Case study: Avera’s ambitious risk adjustment strategy – ideation, goals, and outcomes so far

1:30

Case study: How Providence Health Plan has tied risk adjustment and quality together

2:30

Wrap up and Adjourn

 

Venue

Las Colinas, TX

Meeting is being held at the Health Plan Alliance Headquarters

290 E. John Carpenter Freeway, Bldg 1
Irving, TX 75062


Hotel information

Aloft Las Colinas

122 E John Carpenter Fwy
Irving, TX 75062
972.717.6100
Website

Our group rate is $169 call or go online to make your reservation by January 27th.  If you have trouble booking a room contact Denise Venegas at 972.819.1217 or dvenegas@quorumhotels.com  and she will be happy to assist you.

 

 

Attire

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 Dallas/Ft Worth International airport and Love Field airport is approximately $25 one-way.  UberX is $17-20.  The hotels above provide a shuttle to the Alliance office at 290 E John Carpenter Fwy, Bldg 1, which is where the meeting will be held.



Dallas weather

View the latest weather forecast.
Documents
2/10/2020

Risk Adjustment Case Study from Optima
Optima Health shares a case study on risk adjustment, including their approach to revenue projections, during the Risk Adjustment Master Class held in Febriary 2020.

2/10/2020

Best Practices in Vendor Management: Medigold
Mount Carmel Health Plan (Medigold) presents on vendor management and provides an overview of lessons learned and winning approaches during the Risk Adjustment Master Class held in February 2020.

2/7/2020

Preparing for Risk Adjustment Audits
AvMed shares how they improved risk adjustment results by redesigning their workflow process to assist with audit data collection. Presented at the Risk Adjustment Master Class in February 2020.

2/7/2020

Risk Adjustment Staffing and Orgnanizational Structures
Health New England leads a discussion on the various organizational structures for health plan risk adjustment departments at the Risk Adjustment Master Class in February, 2020.

2/7/2020

Risk Adjustment Functions: Outsourcing vs. Insourcing
Presbyterian Health Plan shares the considerations and challenges in deciding whether to insource or outsource various risk adjustment functions at the Risk Adjustment Master Class in February, 2020.

2/7/2020

Tying Risk Adjustment with Quality: Providence Case Study
Providence Health Plans presents how they tied risk adjustment and quality together with great success at the Risk Adjustment Master Class in February, 2020.

2/7/2020

Risk Adjustment Audit Tool: Providence Case Study
Providence Health Plans shares how their innovative risk adjustment audit tool enables successful audits at the Risk Adjustment Master Class in February, 2020.

2/7/2020

Risk Adjustment Organizational Charts
A collection of risk adjustment organizational charts gathered from health plans attending the Risk Adjustment Master Class in February 2020.

2/7/2020

Risk Adjustment as a Population Health Strategy
Avera Health Plan provides insight into their approach for leveraging risk adjustment as a population health strategy. Shared at the Risk Adjustment Master Calss in February 2020.

2/4/2020

Scott and White Risk Adjustment Vendor Matrix
Scott and White Risk Adjustment Vendor Matrix created for the February 2020 HPA Risk Adjustment Master Class

Attendees

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

  • Lori Asmus
  • ALLIANCE MEMBER
  • Director, Risk Adjustment at Network Health
  • Pamela Bower
  • ALLIANCE MEMBER
  • Program Manager, Risk Adjustment at Presbyterian Health Plan
  • Jason Brockett
  • ALLIANCE MEMBER
  • Risk Adjustment Analytics Manager at SelectHealth
  • Ngoc Bui-Tong
  • ALLIANCE MEMBER
  • Director of Health Care Economics at Santa Clara Family Health Plan
  • Andrew Bundy
  • ALLIANCE MEMBER
  • Manager, Risk Adjustment at Presbyterian Health Plan
  • Joseph Caldwell
  • ALLIANCE MEMBER
  • Chief Financial Officer at Alliant Health Plans
  • Fernando Cedano
  • ALLIANCE MEMBER
  • Business Data Analyst at Alliant Health Plans
  • Allen Chen
  • ALLIANCE MEMBER
  • Director of Network Operations at Central Health Plan of California
  • David DiGiuseppe
  • ALLIANCE MEMBER
  • VP of Healthcare Economics at Community Health Plan of Washington
  • Patricia Donoghue
  • ALLIANCE MEMBER
  • Vice President of Accounting & Finance at HealthTeam Advantage
  • Jill Duhr
  • ALLIANCE MEMBER
  • Director of Outpatient CDI at Scott & White Health Plan
  • Jessica Dupont
  • ALLIANCE MEMBER
  • Director of Risk Adjustment at Health New England
  • Sarah Engle
  • ALLIANCE MEMBER
  • Risk Adjustment and Claims Analytics Supervisor at Western Health Advantage
  • Thomas Glasner
  • ALLIANCE MEMBER
  • Actuarial Analyst at Health First Health Plans
  • Sara Hansen
  • ALLIANCE MEMBER
  • Manager of Risk Adjustment Clinical Operations at Avera Health Plans (DAKOTACARE)
  • Amber Harris
  • ALLIANCE MEMBER
  • Director Risk Adjustment at Mount Carmel Health Plan (MediGold)
  • Ed Lee
  • ALLIANCE MEMBER
  • Exec Director Healthcare Economics Outcomes at Indiana University Health Plans
  • Gregory Limon
  • ALLIANCE MEMBER
  • Director of Revenue Cycle and Data Management at Sharp Health Plan
  • Zoe Lutes
  • ALLIANCE MEMBER
  • Director of UM & Risk Adjustment Solutions at Health Alliance Medical Plans
  • Amber Malone-Wright
  • ALLIANCE MEMBER
  • Manager of HCC Coding & Encounter Data at CHRISTUS Health Plan
  • Shelly Marsh
  • ALLIANCE MEMBER
  • Quality Audit Manager at Physicians Health Plan
  • Amanda Potter
  • ALLIANCE MEMBER
  • Manager Data Analytics at Physicians Health Plan
  • Jean Rao
  • ALLIANCE MEMBER
  • Pharmacy Manager at Chinese Community Health Plan
  • Dean Ratzlaff
  • ALLIANCE MEMBER
  • Actuary at Sentara Health Plans (Optima)
  • Stephanie Rogers
  • ALLIANCE MEMBER
  • VP, Government Programs at Scott & White Health Plan
  • Karen Rosen
  • ALLIANCE MEMBER
  • Manager, Government Revenue Analytics at Providence Health Plans
  • Wesley Sanders
  • ALLIANCE MEMBER
  • Vice President, Finance & Analytics at Alliant Health Plans
  • Mike Sloan
  • ALLIANCE MEMBER
  • Risk Adjustment Reconciliation Analyst at Mount Carmel Health Plan (MediGold)
  • Sunita Varghees
  • ALLIANCE MEMBER
  • System Vice President, CDI at Scott & White Health Plan
  • Pam Walsh
  • ALLIANCE MEMBER
  • Applications Services Manager at Health Alliance Medical Plans
  • Susan Waterman
  • ALLIANCE MEMBER
  • Director, Risk Adjustment at Scott & White Health Plan
  • Rebecca Welling
  • ALLIANCE MEMBER
  • Senior Director Coding Compliance at Providence Health Plans
  • Mary Wertz
  • ALLIANCE MEMBER
  • HCC Coding Auditor Manager at Presbyterian Health Plan
  • Ray Evans
  • SPONSOR
  • Vice President of Sales at Centauri Health Solutions
  • Steve Morris
  • SPONSOR
  • VP Sales, New Business Development at Cotiviti, Inc.
  • Will Stabler
  • SPONSOR
  • Strategic Business Development at Advantasure
  • Kim Staley
  • SPONSOR
  • Sales Support Manager at Centauri Health Solutions
  • Kunal Yajnik
  • SPONSOR
  • Business Development Manager at Pareto Intelligence
Speakers