This year’s annual conference will take place as a live-streamed virtual event November 9-11, 2020. Take a look at just a few of the industry experts and sessions we’ve lined up.

Keynote: Cigna’s Dave Meyer

Dave Meyer, vice president, risk adjustment and quality, Cigna, will kick off the first day of the main conference at 10:10 a.m. Tuesday, Nov. 10, with a keynote that analyzes the true impact of COVID-19 on risk adjustment. He’ll cover the possible rebound effect in 2021 with increased claims and a potential negative impact on overall revenue, the damage caused by lack of claims in 2020 that will impact the risk score run rate, and how the RADV audit postponement may impact plans in 2021 and future years.

CMS’ Ashby Wolfe

Following Meyer’s presentation, Ashby Wolfe, M.D., MPP, MPH, regional chief medical officer, Centers for Medicare & Medicaid Services, will provide an update on CMS regulations during these unprecedented times. She will discuss changes to the 2021 Physician Fee Schedule, updates of 2021 Medicare Advantage policies, and current activities at the CMS Innovation Center, including a look at models that have two-sided risk sharing requirements.

General sessions will address value-based agreements, telehealth, encounter data, and more

Eleesa Marnagh, MPH, director, data strategy, Pulse8, and John Barkley, vice president, enterprise risk adjustment & data integrity, EmblemHealth/ConnectiCare,will take a deep dive into how to thrive in value-based payment agreements by addressing the components of high performance. Attendees will gain an understanding of how utilization management, network management, cost of care, and provider and patient engagement all play a role in high-quality performance. Marnagh and Barkley will also share tools and strategies to implement and improve risk adjustment, utilization management, and network keepage programs.

Learn how to incorporate telehealth into your long-term plan for risk adjustment during a session with Bahar Sedarati, M.D., national medical director, Humana. She’ll examine the differences in telehealth opportunities between Medicare, Medicaid, and commercial to maximize your efforts and explain how to capitalize on new CMS flexibility of virtual visits. 

Improve encounter data collection and accurate submission to CMS during a session that goes over preparation for a complete transition to EDPS by January 2022 to streamline the change and how to generate new work processes to ensure operational changes are in place.

Listen in to a panel discussion on how to incorporate the risk adjustment playbook to attain organizational goals. The panel will analyze every single component of the risk adjustment program to identify areas of improvement, define and incorporate best practices and targets for each role within the process, and create and implement metrics to achieve and ensure quality from your team to operate efficiently and successfully.

Another panel will focus on how to create a team approach among your risk adjustment, quality measures, and care management teams. Panelists will provide suggestions on how to reduce conflicting messages and establish one streamlined communication approach, remove silos and create a value proposition from all three teams to identify a universal goal, and capture all vital information from all three teams in one visit and creating efficiency within your workflow.

Concurrent track sessions

We’ll explore the ins and outs of clinical document and coding precision in a series of sessions throughout the two days of the main conference. Topics include capturing codes through virtual health care, how to minimize the time lag by improving real-time coding and documentation, and how to develop a process to establish a successful outpatient CDI department.

The technology solution selection and integration track will feature sessions on strategies to improve health data access through interoperability, how to maximize the effectiveness of retrospective chart review and retrieval, and how to optimize return on investment through virtual encounters with members.

The audit uncertainty and preparation track will include a regulatory update on commercial risk adjustment, how to mitigate risk and prepare your team for a RADV audit, and a look at the successes of recently audited plans.

The provider engagement track will feature sessions on provider education in a virtual world, strategies to avoid provider burn out, and how to improve your current provider incentives program to obtain desired quality.

Bonus features: Roundtables, tools and technology spotlight, and extra networking time

Attendees will also be able to participate in roundtable discussion on how to utilize ICD-10 Z codes to capture social determinants of health; documentation success for major depression, BMI cancer, and diabetes; HCC coding and documentation issues; and strategies to increase member engagement and increase visits during the pandemic.

This year’s conference will also feature a tools and technology spotlight throughout the two days featuring experts who will discuss how their solutions can improve efficiencies in your organization. Scheduled spotlights include Bryan Lee, vice president of solutions, Apixio and Will Dukes, director of business development, ICare Intelligence.

We’ve also scheduled enhanced networking time in the virtual exhibit hall throughout the two days so you can mix and mingle and also learn the latest and greatest advancements in improving your risk adjustment and quality programs.

Editor’s note: The virtual 16th Risk Adjustment Forum will take place Nov. 9-11. Click here to see the complete agenda, including pre-conference workshops, and how to register.