View Agenda | The Risk Adjustment Forum | A RISE Health Conference

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RISE Risk Adjustment Forum
May 20-22, 2024
New Orleans, LA

Agenda

Monday - May 20, 2024

9:30 AM 10:30 AM

8:30 AM 9:30 AM

7:30 AM 8:30 AM

6:30 AM 7:30 AM

Registration Desk Opens and Networking Breakfast

Workshops 10:30 AM - 6:00 PM 9:30 AM - 5:00 PM 8:30 AM - 4:00 PM 7:30 AM - 3:00 PM

Break: 11:00AM - 11:15AM   

Lunch: 1:00PM - 1:30PM  

Break: 3:00PM - 3:15PM 

 

Track Chairs:

10:30 AM 6:00 PM

9:30 AM 5:00 PM

8:30 AM 4:00 PM

7:30 AM 3:00 PM

Workshop A

Workshop A - Risk Adjustment Practitioner

  • The essentials of and differences between Medicare Advantage, Commercial and Medicaid risk adjustment   
  • Understanding how risk scores are calculated  
  • Making sense of varying payment models  
  • An intro into using data and predictive analytics to optimize your risk adjustment practices  
  • Tools for achieving data accuracy  
  • Where do we stand with the transition from RAPS to EDS? The latest in a long journey  
  • Provider engagement strategies that will impact your risk adjustment initiatives  
  • Risk adjustment vendor selection and management  
  • Determining whether you need RA vendors  
  • How do you effectively vet potential vendors and ultimately select them?  
  • Strategies for on-going, thorough vendor management  
  • The future of risk adjustment – what you need to know to stay ahead of possible changes  
  • Initial steps for preparing for a RADV audit  
  • Which staff is essential to overseeing your RADV audit prep?  
  • Staying ahead – key items to monitor well in advance of an actual audit  

  

Laura Sheriff, RN, MSN, CPC, CRC,
Risk Adjustment Consultant, Vice President, Risk Adjustment  
Southwestern Health Resources 

 

Ava Johnson, Associate Director, Ambulatory CDQI  
Mount Sinai Hospital, NYC 
Second Half of the Day Presenter 

Donna Malone, CPC, CRC, AAPC Approved Instructor, AHCCA, RAP 
Director Risk Capture, Population Health Management  
Mass General Brigham 

10:30 AM 6:00 PM

9:30 AM 5:00 PM

8:30 AM 4:00 PM

7:30 AM 3:00 PM

Workshop B

Workshop B - Advanced HCC Auditor

The HCC Coding for Accuracy workshop is not just for those directly involved in HCC coding work. It is designed for other disciplines, as well, including finance and analytics professionals. Join us for an introduction to best practices, the opportunity to work through case examples, and to share experiences with your peers. This workshop will zero-in on regulatory compliance while teaching you how to optimize the accuracy of the information gathered and submitted at the practice level. What you will also learn about the way charting is often done, how to overcome “disconnect” with the clinicians and how their typical charting practices and EMRs can create significant problems, and how RADV views documentation in contrast with the way clinicians were taught and EMRs were built initially. Please note: Attendees are encouraged to bring questions to pose to our expert workshop facilitators and to table for the group. We provide your workbook which includes copies of the slide deck. You will not need your coding manuals, but most people bring a laptop or a tablet, as well, for note-taking.   

Dialogue, interact and work in small, facilitated groups with peers and colleagues   

  • Understanding the financial overlay – HCC codes mapping to risk adjustment scores   
  • A single coding and documentation process for  
  • Risk adjustment   
  • Skill development on choosing diagnoses from portions of the encounter – permitted and not permitted   
  • Clinical documentation barriers for risk adjustment purposes (data validation audit risks)  

  

Deb Curry, MBA, RHIA, CCS-P, CRC, RAP, AHCCA,
Director Risk Adjustment & Recoveries   
Paramount Healthcare/ProMedica Health System 

 

Colleen Gianatasio,
Director Clinical Documentation Integrity and Coding Compliance 
Capital District Physician’s Health Plan (CDPHP) 

  

Susan Waterman RHIT, CCS, CPC, CRC,
Director of Risk Adjustment  
Baylor Scott and White Healthcare 

10:30 AM 6:00 PM

9:30 AM 5:00 PM

8:30 AM 4:00 PM

7:30 AM 3:00 PM

Workshop C

Workshop C - RADV Audit Preparation for Success

*Half Day Only* 9:30AM-1:00PM

 

Break: 11:00AM - 11:15AM 

Lunch: 1:00PM - 1:30PM 

 

  • Examine the changes to RADV extrapolation to confirm understanding and educate your team 
  • Distinguish critical stakeholders needed when preparing for an audit 
  • Capitalize on sample audits as team preparation for an actual CMS audit 
  • Analyze current coding to ensure accuracy to avoid complications during an audit 
  • Explore the differences in preparation for small, medium, and larger organizations to identify alternative approaches 

 

Donna Malone, CPC, CRC, AAPC Approved Instructor, AHCCA, RAP 
Director Risk Capture, Population Health Management  
Mass General Brigham 

6:00 PM 7:00 PM

5:00 PM 6:00 PM

4:00 PM 5:00 PM

3:00 PM 4:00 PM

Networking Cocktail Reception

Join us for drinks, hors d’oeuvres, and face-to-face networking with peers.  

Tuesday - May 21, 2024

8:50 AM 9:50 AM

7:50 AM 8:50 AM

6:50 AM 7:50 AM

5:50 AM 6:50 AM

Registration Desk Opens and Networking Breakfast

8:50 AM 7:15 PM

7:50 AM 6:15 PM

6:50 AM 5:15 PM

5:50 AM 4:15 PM

Exhibit Hall Open

9:50 AM 10:00 AM

8:50 AM 9:00 AM

7:50 AM 8:00 AM

6:50 AM 7:00 AM

Welcome Remarks

Deb Curry, MBA, RHIA, CCS-P, CRC, RAP, AHCCA
Director Risk Adjustment & Recoveries
Paramount Healthcare/ProMedica Health System 

Rafi Cices
Head of Risk Adjustment, Coding and Billing  
City Block Health 

10:00 AM 10:40 AM

9:00 AM 9:40 AM

8:00 AM 8:40 AM

7:00 AM 7:40 AM

Keynote Address: Ensuring Health Care is Equitable, Accessible, and Competent for the Disability Community

Chanda Hinton, a disability healthcare advocate, will share her story about how she founded The Chanda Center for Health, which provides access to holistic, collaborative, accessible and disability competent healthcare programs to individuals with physical disabilities. 

  

  • Explore the health care barriers that individuals with long-term disability face 
  • Determine what is disability competent care and how it improves the quality of life for individuals with disabilities 
  • Review how and why medical providers and professionals need to apply disability competent care in their practices 

 

Chanda Hinton
Founder and Executive Director  
Chanda Center for Health 

10:40 AM 11:25 AM

9:40 AM 10:25 AM

8:40 AM 9:25 AM

7:40 AM 8:25 AM

OIG Fireside Chat – – Evaluating Regulatory Priorities for 2024

Join this lively Fireside Chat as OIG representatives discuss key priorities for 2024, including OIG's Strategic Plan, Medicare Advantage audit preparation best practices, and a high-level overview of the new OIG MA Toolkit.   

Moderator:  

Ana Handshuh,
Principal 
CAT5 Strategies 

 

Speakers:  

Chris Bresette
Director, Medicare Part C Audits 
HHS Office of Inspector General 

  

Carolyn Kapustij,
Senior Advisor for Managed Care 
HHS Office of Inspector General 

11:25 AM 11:45 AM

10:25 AM 10:45 AM

9:25 AM 9:45 AM

8:25 AM 8:45 AM

Networking Break

11:45 AM 12:30 PM

10:45 AM 11:30 AM

9:45 AM 10:30 AM

8:45 AM 9:30 AM

CMS Regulation Update

Part 1 

CMS Regulation Update 

  • Examine Enhancements to Medicare Advantage and Medicare Part D  
  • Investigate effects of extrapolation of the error rate    
  • Move beyond the changes – explore Best Practices & Real-Life Experiences   

Donna Malone, CPC, CRC AAPC Approved Instructor, AHCCA, RAP 
Director Risk Capture, Population Health Management   
Mass General Brigham 

 

Part 2 

ACA Risk Adjustment Update  

  • Examine the latest updates in ACA Risk Adjustment, including regulatory changes  
  • Grasp the nuances of ACA RADV Audits to prepare effectively 
  • Evaluate the Influence of Risk Adjustment on ACA Marketplace Dynamics 

Gabriel McGlamery J.D.
Director of Commercial Market Strategic Integration
Florida Blue 

12:30 PM 12:35 PM

11:30 AM 11:35 AM

10:30 AM 10:35 AM

9:30 AM 9:35 AM

Session Transition

Concurrent Sessions 12:35 PM - 1:20 PM 11:35 AM - 12:20 PM 10:35 AM - 11:20 AM 9:35 AM - 10:20 AM
Track Chairs:

12:35 PM 1:20 PM

11:35 AM 12:20 PM

10:35 AM 11:20 AM

9:35 AM 10:20 AM

Track A: Regulatory Compliance Methods

Track A - Development of a RA Compliance Program

  • Establishing compliant processes and oversight roles 
  • Review RADV Rule and recent OIG audits and reports effect on Compliance Submissions 
  • Examine how frequently you are and should be documenting 

  

Colleen Gianatasio
Director Clinical Documentation Integrity and Coding Compliance 
Capital District Physician’s Health Plan (CDPHP) 

Corrina Rottum,
Director, Clinical Documentation Integrity  
Panoramic Health 

12:35 PM 1:20 PM

11:35 AM 12:20 PM

10:35 AM 11:20 AM

9:35 AM 10:20 AM

Track B: Risk Adjustment Operations

Track B - Remember the Member: Unveiling Hidden Health Influencers through Advanced Analytics

  • Address common data challenges around member population analytics 
  • Examine how analytics can be leveraged to better understand your members 
  • Learn how to action your analytical insights to improve member engagement and provider relationships 

Jennifer Hawkes 
Government Funding Risk Programs Manager 
Blue Cross of Idaho 

Vijaya Vishwanathan 
Director, Product 
Episource 

Scott Roeber
Manager, Client Services 
Episource 

Concurrent Sessions 1:20 PM - 1:35 PM 12:20 PM - 12:35 PM 11:20 AM - 11:35 AM 10:20 AM - 10:35 AM
Track Chairs:

1:20 PM 1:35 PM

12:20 PM 12:35 PM

11:20 AM 11:35 AM

10:20 AM 10:35 AM

Track A: Regulatory Compliance Methods

Track A - Tools & Technology Spotlights

Leading service providers will showcase their offerings in a quick-pitch setting. Evaluate the latest and greatest tech tools to bring back to your organization. 

 

Taking Regulatory Audits Head On 

Introducing the Health Language Regulatory Audit Module  

  

 

Nick Volpe,
Sales Director  
Wolters Kluwer, Health Language 

1:20 PM 1:35 PM

12:20 PM 12:35 PM

11:20 AM 11:35 AM

10:20 AM 10:35 AM

Track B: Risk Adjustment Operations

Track B - Tools & Technology Spotlights

Leading service providers will showcase their offerings in a quick-pitch setting. Evaluate the latest and greatest tech tools to bring back to your organization.

1:35 PM 2:35 PM

12:35 PM 1:35 PM

11:35 AM 12:35 PM

10:35 AM 11:35 AM

Networking Lunch

Concurrent Sessions 2:35 PM - 3:20 PM 1:35 PM - 2:20 PM 12:35 PM - 1:20 PM 11:35 AM - 12:20 PM
Track Chairs:

2:35 PM 3:20 PM

1:35 PM 2:20 PM

12:35 PM 1:20 PM

11:35 AM 12:20 PM

Track A: Regulatory Compliance Methods

Track A - Deep Dive into OIG Audits & Toolkit Experience

  • Discover what led to the creation of the OIG toolkit  
  • Uncover OIG’s priorities regarding Medicare Advantage audits 
  • Review how the toolkit improves the accuracy of submitted high risk diagnoses  

  

Moderator:
Carolyn Kapustij
Senior Advisor for Managed Care 
HHS Office of Inspector General  

  

Chris Bresette
Director, Medicare Part C Audits 
HHS Office of Inspector General 

2:35 PM 3:20 PM

1:35 PM 2:20 PM

12:35 PM 1:20 PM

11:35 AM 12:20 PM

Track B: Risk Adjustment Operations

Track B - The Value of Complete Code Capture

  • Discuss the pros and cons of complete code capture in terms of RADV audit and compliance oversight 
  • Hear about the greater value of having all of the diagnosis codes captured from the medical record to include in your risk adjustment analytics 
  • Consider how only looking for additive codes loses much of the value of what you wanted to get out of coding the chart 

Jimmy Liu,
VP Analytics and MRR Solutions 
Advantmed 

 

Jenni Monfils, CPC, CDEO, CRC | AVP,
Risk Adjustment Coding and Compliance 
Molina HealthCare

3:20 PM 3:25 PM

2:20 PM 2:25 PM

1:20 PM 1:25 PM

12:20 PM 12:25 PM

Session Transition

Concurrent Sessions 3:25 PM - 4:10 PM 2:25 PM - 3:10 PM 1:25 PM - 2:10 PM 12:25 PM - 1:10 PM
Track Chairs:

3:25 PM 4:10 PM

2:25 PM 3:10 PM

1:25 PM 2:10 PM

12:25 PM 1:10 PM

Track A: Regulatory Compliance Methods

Track A - V28 Model and the Risk Score Effects

  • Examine revenue impact and program funding   
  • Evaluate impact to the MA capitation rate and risk adjustment methodology  
  • Review real life examples of both positive and negative experiences  

  

Donna Malone, CPC, CRC, AAPC Approved Instructor, AHCCA, RAP 
Director Risk Capture, Population Health Management  
Mass General Brigham 

Laura Sheriff, RN, MSN, CPC, CRC,
Risk Adjustment Consultant, Vice President, Risk Adjustment  
Southwestern Health Resources 

Chris Trygstad
Vice President, Product 
Biomedix 

3:25 PM 4:10 PM

2:25 PM 3:10 PM

1:25 PM 2:10 PM

12:25 PM 1:10 PM

Track B: Risk Adjustment Operations

Track B - Back – to – Basics: Practical Operations RA Work

  • Receive practical guidance on the best way to organize your team 
  • Explore various methods on records request  
  • Streamline processes and data retrieval  
  • Impact on chart retrieval timelines due to end of public health emergency  

Prince Baawuah, DrPH, MPH, CSM
Founder / Chief Tutor 
The HEALS Academy 
Former Health Insurance Specialist
CMS 

 

Dr. Shannon Decker, PhD, MBA, MBA, M.Ed., M.Ed,
Principal   
VBC One  

4:10 PM 4:35 PM

3:10 PM 3:35 PM

2:10 PM 2:35 PM

1:10 PM 1:35 PM

Networking Break

Concurrent Sessions 4:35 PM - 5:20 PM 3:35 PM - 4:20 PM 2:35 PM - 3:20 PM 1:35 PM - 2:20 PM
Track Chairs:

4:35 PM 5:20 PM

3:35 PM 4:20 PM

2:35 PM 3:20 PM

1:35 PM 2:20 PM

Track A: Regulatory Compliance Methods

Track A - Master Regulatory Compliance: OIG Audits

  • Explore ‘Dirty Dozen’ codes and how to best mitigate risk     
  • Create robust audit response plans including a response team and a written plan   
  • Learn strategies to enhance documentation workflows, reducing the risk of discrepancies and non-compliance  

  

John M. Barkley
Vice President, Enterprise Risk Adjustment & Data Integrity 
EmblemHealth/ConnectiCare 

  

Ana Handshuh
Principal 
CAT5 Strategies 

4:35 PM 5:20 PM

3:35 PM 4:20 PM

2:35 PM 3:20 PM

1:35 PM 2:20 PM

Track B: Risk Adjustment Operations

Track B - Exploring Methods for Enhanced Coding Accuracy

  • Examine strategies on how to build a successful coding team   
  • Implement a coding process around new, cutting-edge technology 
  • Recognize common coding errors and prevention tips 

Jeannine Bumford, Director
Risk Adjustment Operations 
Christus Health 

 

5:20 PM 5:25 PM

4:20 PM 4:25 PM

3:20 PM 3:25 PM

2:20 PM 2:25 PM

Session Transition

5:25 PM 6:10 PM

4:25 PM 5:10 PM

3:25 PM 4:10 PM

2:25 PM 3:10 PM

Exploring Impacts of Social Determinants of Health and Health Equity

  • Review how the social determinants of health codes are being captured  
  • Examine programs being put into place and member outreach  
  • Integrate considerations of social determinants specific to sickle cell populations 

 

Moderator:  

Deb Curry, MBA, RHIA, CCS-P, CRC, RAP, AHCCA
Director Risk Adjustment & Recoveries 
Paramount Healthcare/ProMedica Health System 

Tina Dueringer, BSN, RN, CCM, PCC 
Vice President, Clinical & Quality 
Rebellis Group, LLC  

Jessica Assefa 
President & CEO 
Ameropia Advisors, LLC 

6:10 PM 6:15 PM

5:10 PM 5:15 PM

4:10 PM 4:15 PM

3:10 PM 3:15 PM

Chairperson Closing Remarks

Deb Curry, MBA, RHIA, CCS-P, CRC, RAP, AHCCA
Director Risk Adjustment & Recoveries
Paramount Healthcare/ProMedica Health System 

Rafi Cices
Head of Risk Adjustment, Coding and Billing  
City Block Health 

6:15 PM 7:15 PM

5:15 PM 6:15 PM

4:15 PM 5:15 PM

3:15 PM 4:15 PM

Networking Cocktail Reception

Join us for drinks, hors d’oeuvres, and face-to-face networking with peers.

Wednesday - May 22, 2024

8:50 AM 9:50 AM

7:50 AM 8:50 AM

6:50 AM 7:50 AM

5:50 AM 6:50 AM

Registration Desk Opens and Networking Breakfast

8:50 AM 2:30 PM

7:50 AM 1:30 PM

6:50 AM 12:30 PM

5:50 AM 11:30 AM

Exhibit Hall Open

9:50 AM 10:00 AM

8:50 AM 9:00 AM

7:50 AM 8:00 AM

6:50 AM 7:00 AM

Welcome Remarks and Day One Takeaways

Deb Curry, MBA, RHIA, CCS-P, CRC, RAP, AHCCA
Director Risk Adjustment & Recoveries
Paramount Healthcare/ProMedica Health System 

Rafi Cices
Head of Risk Adjustment, Coding and Billing  
City Block Health 

 

10:00 AM 10:45 AM

9:00 AM 9:45 AM

8:00 AM 8:45 AM

7:00 AM 7:45 AM

Evaluate Updates to Accountable Care Organizations (ACOs)

  • Review the impact of models to providers  
  • Protect against inappropriate risk score growth  
  • Learn about the nuances of the model program including increased predictability for model participants 

 

Moderator:  

Dr. Shannon Decker, PhD, MBA, MBA, M.Ed., M.Ed 
Principal   
 VBC One 

Susan Waterman RHIT, CCS, CPC, CRC
Director of Risk Adjustment 
Baylor Scott and White Healthcare 

Adrian White 
VP - Quality Operations, Clinical Safety & Patient Experience 
Southwestern Health Resources 

 

10:45 AM 11:30 AM

9:45 AM 10:30 AM

8:45 AM 9:30 AM

7:45 AM 8:30 AM

Risk-Adjustment Coding in Value-Based Care

  • Explore the similarities and differences between Value-Based Care and Risk Adjustment  
  • Learn how aligning coding practices with value-focused methodologies can enhance overall performance 
  • Uncover VBC approaches that empower risk adjustment professionals to excel in their coding endeavors 

 

Moderator:

Rafi Cices
Head of Risk Adjustment, Coding and Billing  
City Block Health 

Jeannine Bumford
Director, Risk Adjustment Operations 
Christus Health 

Eric Hansen, DO, FAAFP,
Physician  
Hansen Medical 

Laura Sheriff, RN, MSN, CPC, CRC
Risk Adjustment Consultant, Vice President, Risk Adjustment  
Southwestern Health Resources 

11:30 AM 11:45 AM

10:30 AM 10:45 AM

9:30 AM 9:45 AM

8:30 AM 8:45 AM

Networking Break

Concurrent Sessions 11:45 AM - 12:30 PM 10:45 AM - 11:30 AM 9:45 AM - 10:30 AM 8:45 AM - 9:30 AM
Track Chairs:

11:45 AM 12:30 PM

10:45 AM 11:30 AM

9:45 AM 10:30 AM

8:45 AM 9:30 AM

Track A: Innovative Solutions for Risk Adjustment Advancement

Track A - Greater Care: Innovative Clinical Partnerships that Revolutionize Risk Adjustment

  • Leveraging Thoughtful Cost Distribution Strategies 
  • Incentivizing Clinical Quality and Improving Patient Experience 
  • Creating Value to Providers 

  

Amy Page,
Vice President, Growth 
Greater Good Health 

  

Stan Hornbacher,
Director, Risk Adjustment  
Blue Shield of California 

11:45 AM 12:30 PM

10:45 AM 11:30 AM

9:45 AM 10:30 AM

8:45 AM 9:30 AM

Track B: Payer/Provider Alignment

Track B - The Art of Provider Education

  • Educate providers on the reason for risk adjustment program, and how proper documentation can affect member care 
  • Implement an analytic program that will give your provider real time data at the point of care 
  • Create a meaningful incentive program that will move the needle with your provider offices 

Ryan Dodson, CRC 
Risk Adjustment Consultant 
Choice Medical Group  

Ava Johnson
Associate Director, Ambulatory CDQI  
Mount Sinai Hospital, NYC 

Eirinn Erny, M.D.
VP / Medical Director – Clinical Documentation Excellence  
Ochsner Health Network 

Concurrent Sessions 12:30 PM - 1:15 PM 11:30 AM - 12:15 PM 10:30 AM - 11:15 AM 9:30 AM - 10:15 AM
Track Chairs:

12:30 PM 1:15 PM

11:30 AM 12:15 PM

10:30 AM 11:15 AM

9:30 AM 10:15 AM

Track A: Technology Solutions for Risk Adjustment Advancement

Track A - Pros and Cons of Using In-home Assessments as a Strategy

  • Examine strategies to ensure accurate reporting and improved patient outcomes 
  • Review limitations to in-home assessments and avoid poor assessments   
  • Explore the governments acceptance and payment for in-home assessments  

  

Mandvi Tandon
Executive in Risk Adjustment & Quality 

Adrian White
VP - Quality Operations, Clinical Safety & Patient Experience 
Southwestern Health Resources 

Kacey Holman, Manager,
Risk Adjustment Consulting 
Pareto Intelligence 

12:30 PM 1:15 PM

11:30 AM 12:15 PM

10:30 AM 11:15 AM

9:30 AM 10:15 AM

Track B: Payer/Provider Alignment

Track B - Improving and Executing on Care Coordination Activities

  • Identify ways to better utilize limited clinical resources 
  • Discover ways to augment current staffing models 
  • Being Member-Centric while Improving RA/Quality Value  

Masha Sciolla,
VP, Customer Experience 
Porter 

 

Melissa McVaugh,
Director, Clinical Operations 
Mountain Health CO-OP 

 

John M. Barkley,
Vice President, Enterprise Risk Adjustment & Data Integrity 
EmblemHealth/ConnectiCare  

 

Deb Curry, MBA, RHIA, CCS-P, CRC, RAP, AHCCA,
Director Risk Adjustment & Recoveries 
Paramount Healthcare/ProMedica Health System 

Concurrent Sessions 1:15 PM - 1:30 PM 12:15 PM - 12:30 PM 11:15 AM - 11:30 AM 10:15 AM - 10:30 AM
Track Chairs:

1:15 PM 1:30 PM

12:15 PM 12:30 PM

11:15 AM 11:30 AM

10:15 AM 10:30 AM

Track A: Technology Solutions for Risk Adjustment Advancement

Track A - Tools & Technology Spotlights

Leading service providers will showcase their offerings in a quick-pitch setting. Evaluate the latest and greatest tech tools to bring back to your organization. 

1:15 PM 1:30 PM

12:15 PM 12:30 PM

11:15 AM 11:30 AM

10:15 AM 10:30 AM

Track B: Payer/Provider Alignment

Track B - Tools & Technology Spotlights

Leading service providers will showcase their offerings in a quick-pitch setting. Evaluate the latest and greatest tech tools to bring back to your organization.

1:30 PM 2:30 PM

12:30 PM 1:30 PM

11:30 AM 12:30 PM

10:30 AM 11:30 AM

Networking Lunch

Concurrent Session 2:30 PM - 3:15 PM 1:30 PM - 2:15 PM 12:30 PM - 1:15 PM 11:30 AM - 12:15 PM
Track Chairs:

2:30 PM 3:15 PM

1:30 PM 2:15 PM

12:30 PM 1:15 PM

11:30 AM 12:15 PM

Track A: Technology Solutions for Risk Adjustment Advancement

Track A - Vendor Selection and Partnering

 

  • Evaluate your business needs, examine the “Why?”  
  • Determine who to partner with amid increasing consolidation of providers and payers  
  • Examine appropriate vendor oversight   

 

Moderator:

Rafi Cices
Head of Risk Adjustment, Coding and Billing 
Cityblock Health  

Christina M. Medrano
Sr. Director ACA Risk Adjustment Operations 
Florida Blue  

Kei Shao Tikkanen,
Manager, BoI Strategic Initiatives 
Cityblock Health 

 

2:30 PM 3:15 PM

1:30 PM 2:15 PM

12:30 PM 1:15 PM

11:30 AM 12:15 PM

Track B: Payer/Provider Alignment

Track B - Outpatient Clinical Documentation Integrity

  • Explore best practices on how to create a CDI program  
  • Cultivate cooperative approaches with stakeholders, fostering outreach efforts  
  • Identify best practices for questioning providers  

 

Jenni Monfils, CPC, CDEO, CRC 
AVP, Risk Adjustment Coding and Compliance 
Molina HealthCare 

 

Jeremy Cale Browning, MBA, CPC, CRC,
Director, CDE Performance Management 
Ochsner Health Network 

 

Ekaette Joseph-Isang, MD MBA MPH CPHQ
Principal Consultant  
RiteBridge 

3:15 PM 3:20 PM

2:15 PM 2:20 PM

1:15 PM 1:20 PM

12:15 PM 12:20 PM

Session Transition

3:20 PM 3:55 PM

2:20 PM 2:55 PM

1:20 PM 1:55 PM

12:20 PM 12:55 PM

Fresh Approaches to Convey Risk Adjustment to Senior Leadership

  • Develop effective means of conveying complex concepts to ensure comprehension at leadership levels 
  • Explain changes to provider education that will improve accuracy  
  • Assess the importance of preparation and continued practice to improve the outcomes of various Audits   

  

 

 

Moderator: 

Deb Curry, MBA, RHIA, CCS-P, CRC, RAP, AHCCA,
Director Risk Adjustment & Recoveries 
Paramount Healthcare/ProMedica Health System 

Monica Watson
Corporate Coding Director 
Allegheny Health Network  

Rafi Cices
Head of Risk Adjustment, Coding and Billing 
Cityblock Health 

3:55 PM 4:00 PM

2:55 PM 3:00 PM

1:55 PM 2:00 PM

12:55 PM 1:00 PM

Closing Remarks

Deb Curry, MBA, RHIA, CCS-P, CRC, RAP, AHCCA
Director Risk Adjustment & Recoveries
Paramount Healthcare/ProMedica Health System 

Rafi Cices
Head of Risk Adjustment, Coding and Billing  
City Block Health 

;