Insights & Articles

Revenue & Quality

Regulatory update: HHS restores transgender health protections; 1M enroll in ACA coverage during SEP; AMA vows to advance health equity; and more

RISE summarizes the latest headlines that impact the health care industry.

Population Health & SDoH

Horizon Blue Cross Blue Shield of New Jersey finds success in SDoH pilot program, expands community partnerships

The program addresses social determinants of health (SDoH) needs among members by making the most of its partnerships with health care provider organizations, community health workers, and a community referral platform.

Revenue & Quality

Research roundup: AEP switchers take advantage of OEP; MA beats Medicare in quality, outcomes, and costs; and more

RISE examines the latest research news on Medicare, Medicare Advantage, and Medicaid.

Revenue & Quality

CMS chief medical officer, customer experience expert to present keynotes at Qualipalooza 2021–a RISE hybrid event

RISE is pleased to announce two keynote speakers for Qualipalooza 2021, which will take place June 28-29, 2021 in-person in Orlando and virtually via livestream for those unable to travel.

Population Health & SDoH

Mental health services wane as insurers appear to skirt parity rules during pandemic

A report from the Government Accountability Office paints a picture of an already strained behavioral health system struggling after the pandemic struck to meet the treatment needs of millions of Americans with conditions like alcohol use disorder and post-traumatic stress disorder.

Revenue & Quality

Regulatory roundup: New survey looks at insurers’ role in improving COVID-19 vaccine uptake; CMS wants to repeal requirement that hospitals post private MA rates

RISE summarizes recent headlines that impact Medicare, Medicare Advantage, and Medicaid.

Population Health & SDoH

SDoH in the news: HHS announces actions to improve maternal health; Blue Cross Blue Shield sets goal to reduce racial disparities

RISE looks at recent headlines concerning social determinants of health (SDoH).

Population Health & SDoH

Blue Cross NC launches prevention programs to address food insecurity, nutrition

The health plan’s programs aim to equip individuals and communities struggling with food insecurity with equitable access to healthy foods.

Revenue & Quality

From rotten teeth to advanced cancer, patients feel the effects of treatment delays

Health providers are seeing the consequences of pandemic-delayed preventive and emergency care, from longer hospital stays to more root canals.

Population Health & SDoH

How to achieve true member centricity with a grassroots approach

Here’s how three organizations targeted social determinants of health (SDoH) and accomplished improved health outcomes beyond the clinical walls.

Revenue & Quality

Regulatory roundup: HHS to spend $150M to support underserved communities with COVID-19 response; Medical associations protest CMS prior authorization requirements; and more

RISE summarizes the latest headlines that impact the Department of Health & Human Services, Medicare, and Medicare Advantage.

Revenue & Quality

Regulatory roundup: Nearly 1 in 3 American seniors lack knowledge about their Medicare options; Study examines changes in Medicare spending during COVID-19; and more

RISE summarizes the latest headlines that impact Medicare and Medicare Advantage.

Revenue & Quality

RISE Radio Episode 5: Dr. Heather O’Toole on population health, quality measures, COVID, telehealth, and opioid safety in the ambulatory setting

Join us for the latest episode of RISE Radio, our podcast series that focuses on issues that impact our three communities: Quality & Revenue; Member Acquisition & Experience; and Social Determinants of Health.

Population Health & SDoH

SDoH in the news: The impacts of COVID-19 one year later; NIH to address COVID testing disparities in vulnerable communities; and more

RISE looks at recent headlines concerning social determinants of health (SDoH).

Population Health & SDoH

Pandemic brings digital inclusion to light as critical SDoH

It’s been a digital year like no other due to COVID-19, causing Americans to rely on telehealth, virtual learning, and video chats as their new normal for health care, education, and social interaction. But the heightened reliance on digital tools has increased disparities and inequities among individuals without digital skills and access to internet, computers, or mobile devices.

Revenue & Quality

Regulatory roundup: Legislation introduced to overturn controversial Sunset Rule; OIG report indicates MA could improve the use of NPIs; and more

RISE reviews recent headlines in the news that impact Medicare and Medicare Advantage.

Population Health & SDoH

Survey reveals frontline health care workers face serious mental health challenges due to pandemic

A national survey conducted by the Kaiser Family Foundation and The Washington Post reveals worry and stress related to COVID-19 has negatively affected the mental health of most frontline health care workers.

Medicare Market

The intersection of depression and health plan satisfaction: How MA plans can improve satisfaction in an unsatisfied population

Members diagnosed with depression tend to have comorbidities and often report more access issues and show less satisfaction with their health plan than other members.

RISE National

RISE Radio Episode 4: Ana Handshuh on COVID, behavioral health, and takeaways from RISE National 2021

Join us for the latest episode of RISE Radio, our podcast series that focuses on issues that impact our three communities: Quality & Revenue; Member Acquisition & Experience; and Social Determinants of Health.

Population Health & SDoH

How one health plan improved member engagement, Stars, and quality performance by addressing SDoH

Here’s how UnitedHealthcare, a health insurance plan with benefit programs for individuals and families, employers, and Medicare and Medicaid beneficiaries, leveraged social determinants of health (SDoH) programs to better meet member needs, improve Star ratings, and close quality and HEDIS® gaps.

Population Health & SDoH

How to accelerate SDOH interventions: Insights from RISE’s webinar on social risk analytics

Social risk analytics hold immense potential in achieving business goals, reducing costs and improving the lives of consumers, patients and members. As organizations recognize socioeconomic data’s value, they can capitalize on its full potential with the right mechanism and collaboration.

Revenue & Quality

‘Incredibly concerning’ lawsuit threatens no-charge preventive care for millions

A Texas federal judge, who previously ruled the Affordable Care Act unconstitutional, has signaled his openness to ending the law’s popular coverage requirement for preventive services.

Revenue & Quality

House bill would expand telehealth coverage to include audio-only for MA members

Bipartisan legislation introduced this week would expand telehealth services for seniors during the COVID-19 pandemic.

Revenue & Quality

News notes: CMS extends special enrollment period, releases snapshot on COVID-19; Murthy to serve as US surgeon general for a second time

RISE rounds up the latest headlines from the White House and the Centers for Medicare & Medicaid Services (CMS).

Population Health & SDoH

SDoH in the news: US aims for an equitable vaccine rollout; Medicare beneficiaries struggle to manage chronic conditions due to COVID-19; and more

RISE looks at recent headlines concerning social determinants of health (SDoH).

Population Health & SDoH

Top 5 features of The RISE Summit on Social Determinants of Health

This year’s hybrid event on June 14-15 will bring together cross-sectional thought leaders who aim to drive change in the transition to value-based care. Whether attending in-person in Nashville or virtually via livestream, community-based organizations (CBOs), payers, hospitals/health systems, funders, and manufacturers or government entities will have two jam-packed days to discuss actionable and scalable solutions to address social determinants of health (SDoH) and achieve better outcomes for the most vulnerable populations.

Revenue & Quality

Regulatory roundup: HHS responds to lawsuit, postpones effective date of Sunset Rule; CDC director warns of avoidable surge in COVID cases due to relaxing protocols; and more

RISE summarizes the latest regulatory news that impacts Medicare and Medicare Advantage.

Population Health & SDoH

A reimagined conference experience: The RISE Summit on Social Determinants of Health goes hybrid

What exactly does a hybrid event entail? Here’s your one-stop guide for what to expect at the June 2021 event.

Population Health & SDoH

BCBSA, Feeding America partner to drive education of COVID-19 vaccination

Blue Cross Blue Shield Association (BCBSA) announced this week it has partnered with Feeding America® and its network of 200 food banks to educate Americans about the safety and the effectiveness of the COVID-19 vaccine.

Revenue & Quality

Health care leaders welcome Becerra’s confirmation as HHS secretary

Xavier Becerra was narrowly confirmed as secretary of the Department of Health and Human Services (HHS) on Thursday but health care organizations across the country applauded the move.

Revenue & Quality

Regulatory roundup: MedPAC issues telehealth recommendation in Congressional report; Senate set to confirm Becerra as HHS secretary; and more

RISE reviews the latest headlines that have an impact on Medicare and Medicare Advantage.

Revenue & Quality

The boom in out-of-state telehealth threatens in-state providers

Health provider conflicts, fraud, and access disparity temper the COVID telehealth revolution.

Revenue & Quality

Regulatory roundup: MedPAC disputes AHIP’s blog post on Medicare Advantage spending; Health care groups sue HHS over Sunset Rule; and more

RISE reviews the latest headlines that impact Medicare and Medicare Advantage.

Revenue & Quality

Pandemic aid package includes relief from high premiums

Experts say the two-year expansion of subsidies for most people who buy insurance through the government exchanges would be among the most significant changes to the affordability of private insurance since the passage of the Affordable Care Act.

Revenue & Quality

Designing Medicare Advantage health plan benefits for our changing times

This benefit season, more than any other, it’s critical to address medical services that target complex medical needs and non-medical services that target social factors, to stay competitive.

RISE National

RISE National preview: Infectious disease expert Dr. Luciana Borio on COVID—the past, the present, and the future

Luciana Borio, M.D., who warned the public in an opinion piece published in the Wall Street Journal in late January 2020 about the pending COVID-19 pandemic, will be a keynote speaker at RISE National, a virtual live-streaming event, later this month. In this interview, Dr. Borio talks to RISE about COVID, what’s on the horizon, and what health plans can do to support their members.

Revenue & Quality

RISE Radio Episode 3: How RISE evolved during COVID and what the future holds

Join us for the third episode of RISE Radio, our new podcast series that focuses on issues that impact our three communities: Quality & Revenue; Member Acquisition & Experience; and Social Determinants of Health.

Revenue & Quality

Regulatory roundup: Calls to make Medicare reimbursement for telehealth services permanent; COVID relief package could bring major changes to the ACA; and more

RISE summarizes the latest news involving Medicare, Medicare Advantage, and the Affordable Care Act.

Population Health & SDoH

SDoH in the news: Children’s mental health claims doubled amid pandemic; Health equity medical school curriculum found to improve understanding of SDoH; and more

RISE looks at recent headlines concerning social determinants of health (SDoH).

Revenue & Quality

Regulatory roundup: OIG reports hospitals may upcode severity levels for Medicare patients; AHIP disputes MedPAC report on MA spending; and more

RISE looks at recent headlines that impact Medicare and Medicare Advantage.

Population Health & SDoH

Latest data reinforces racial/ethnic disparities persist in COVID-19 vaccination rates

A recent analysis from Kaiser Family Foundation (KFF) found continued disparities based on state-reported data of COVID-19 vaccinations by race and ethnicity.

Medicare Market

Study: Email, SMS text soar as effective health care consumer engagement channels in 2020, reflecting urgency of COVID-19 communications

Engagys and RISE presented results, insights from fifth annual survey of health care consumer engagement practices during this week’s virtual RISE Medicare Marketing & Sales Summit.

Revenue & Quality

Regulatory update: Biden to nominate Brooks-LaSure to head CMS; Calls for HHS to revamp value-based payment and rein in Medicare spending; and more

RISE summarizes the latest headlines that impact Medicare, Medicare Advantage, and Medicaid.

Population Health & SDoH

Key takeaways from the first meeting of the SDOH Community’s Across the Ecosystem User Group

RISE’s Social Determinants of Health (SDoH) Community held its first Across the Ecosystem User Group meeting last week, led by Jessica Kahn, senior expert, McKinsey & Company, and Denise Harlow, CEO, National Community Action Partnership. The user group connects cross-sectional stakeholders (payers, providers, community-based organizations, government, and funders) to discuss actionable and scalable solutions to SDoH challenges and drive social good. Here are key takeaways from the initial discussion on executive orders from the new administration and the interactive McKinsey & Company dashboard.

Population Health & SDoH

6 reasons to register for RISE’s virtual Medicaid Managed Care Leadership Summit

The live-streaming virtual event will be a one-stop shop for state and federal legislators, health plans, providers, and community-based organizations (CBOs) to gain tactics to navigate a changing environment, move forward amid the pandemic, and further the drive for value-based care.

Revenue & Quality

COVID-19 update: Lockdown led to huge drop in Medicare FFS claims; the link between pandemic and increase in mental health troubles and substance use;

RISE summarizes recent research on the impact COVID-19 has had on outpatient Medicare fee-for-service claims, mental health, and patients with dementia.

Population Health & SDoH

OIG: Thousands of Medicare beneficiaries died of opioid overdoses during onset of the COVID-19 pandemic

A recent Department of Health and Human Services’ Office of Inspector General (OIG) report examines opioid use in Medicare Part D during the first eight months of 2020, the beginning of the COVID-19 outbreak. Here are the key takeaways from the report.

Population Health & SDoH

What Americans really think about social determinants of health

In a recent survey conducted by The Root Cause Coalition (TRCC), researchers found the general population considers economic stability and access to health care the most impactful social determinants of health (SDoH).

Population Health & SDoH

An innovative home-based outpatient therapy model for geriatrics saves money, boosts patient satisfaction

In a recent webinar for the RISE Association, FOX Rehabilitation offered an inside look at its geriatric house calls model to provide outpatient therapy to vulnerable seniors in the comfort of their homes. As an alternative option to the traditional models of post-acute rehabilitation, the program improves patient satisfaction while reducing total cost of care.

Population Health & SDoH

As Vaccine Rollout Expands, Black Americans Still Left Behind

Black Americans are still receiving covid vaccinations at dramatically lower rates than white Americans even as the chaotic rollout reaches more people, according to a new KHN analysis.

Revenue & Quality

Regulatory roundup: New bill would allow audio-only telehealth services to count toward MA risk adjustment; MA satisfaction hits new high;

RISE reviews the latest headlines that impact Medicare, Medicare Advantage, and the Affordable Care Act marketplace.

Population Health & SDoH

How an emergency department social medicine team can improve care for complex needs

A San Francisco-based hospital’s emergency department social medicine (EDSM) team has improved care delivery to patients with psychosocial needs. Here’s what the team has accomplished so far since it formed in October 2017.

Revenue & Quality

Regulatory roundup: Biden appoints acting heads for CMS, HHS; Medicare ACO participation dropped in 2021

RISE summarizes the latest headlines that impact Medicare and Medicaid.

Population Health & SDoH

On Trump’s last full day, nation records 400,000 COVID deaths

On the day before the inauguration of a new president, the country marks a once unthinkable milestone of 400,000 deaths. The winter surge of the pandemic claimed 100,000 Americans in just five weeks.

Population Health & SDoH

Surgeon General releases first report on importance of community health

The report sheds light on the U.S. health disadvantage and the role business leaders can play in improving community health through engagement and investment.

Medicare Market

3 findings from the RISE-Engagys 2020 survey on the state of consumer health care engagement

Engagys and RISE have collaborated once again to release our 5th annual State of Healthcare Engagement Survey. Here’s a sneak peek on what the 2020 findings revealed. Engagys Managing Director Kathleen Ellmore will review the full survey findings during the RISE 2021 Medicare Marketing & Sales Summit, a live-streaming virtual event, Feb. 22-23.

Population Health & SDoH

AHIMA releases 2020 SDoH survey results

The American Health Information Management Association (AHIMA) has released the results from its 2020 social determinants of health (SDoH) survey.

Population Health & SDoH

CMS final rule offers fast-track path for seniors to get access to latest medical technology

The Centers for Medicare & Medicaid Services (CMS) issued a final rule Tuesday that will speed Medicare beneficiaries’ access to the latest advanced devices.

Population Health & SDoH

SDoH in the news: Behavioral health most common treatment in telehealth; Pharmacy deserts linked to vulnerable communities; and more

RISE looks at recent headlines concerning social determinants of health (SDoH).

Revenue & Quality

Regulatory update: CMS approves first Medicaid block grant; HHS extends COVID-19 public health emergency

RISE reviews the latest from the Centers for Medicare & Medicaid Services (CMS) and the Department of Health and Human Services (HHS).

RISE National

Dr. Ezekiel Emanuel to lead blockbuster lineup of keynote speakers at RISE National 2021

Dr. Emanuel,  a member of President-elect Joe Biden’s transition COVID-19 advisory board, will kick off the first day of RISE National on Monday, March 29,  with a keynote address on the future direction of the American health care system.  Also slated to speak at the virtual conference: Tara Lipinski, internationally acclaimed figure skater and Olympic gold medalist; infection disease expert Dr. Luciana Borio, who warned the public in January 2020 about the pending COVID-19 pandemic; Dr. Wendy Sue Swanson, M.D., a leading innovator in digital health, innovation and prevention; and health care futurist Ian Morrison.

Revenue & Quality

4 health care trends to watch in 2021

What’s in store for the RISE Association communities in 2021? We asked experts in Medicare Advantage, quality and revenue, consumer engagement, and social determinants of health for their predictions on trends that will impact the industry in the upcoming year. Spoiler alert: COVID-19 will continue to play a big role.

Population Health & SDoH

CMS issues new SDoH guidance for states to improve beneficiary health outcomes and lower costs

The Centers for Medicare & Medicaid Services (CMS) on Thursday issued new guidance for states to address social determinants of health (SDoH) in Medicaid and the Children’s Health Insurance Program (CHIP).

Population Health & SDoH

Social determinants of health funding included in COVID-19 omnibus bill

The new bill includes $3 million in funding to establish a social determinants of health (SDoH) pilot program.

Revenue & Quality

Inside the first chaotic days of the effort to vaccinate America

Within just a few days, the logistical barriers of the vaccine made by Pfizer and BioNTech were laid bare. Many officials now hang their hopes on Moderna, whose vaccine comes in containers of 100 doses, doesn’t require deep freezing and is good for 30 days from the time it’s shipped.

Population Health & SDoH

Trusted messengers may help disenfranchised communities overcome vaccine hesitancy

Persuading vulnerable low-income and ethnic communities hit hard by the coronavirus to take a new vaccine may be challenging. But established local health leaders, like a group in Rochester, Minnesota, home of the Mayo Clinic, may be one answer.

Revenue & Quality

Supply is limited and distribution uncertain as COVID vaccine rolls out

High stakes and big challenges await as the U.S. prepares to roll out vaccines against COVID-19, with front-line health care workers and vulnerable nursing home residents recommended as the top priority.

Population Health & SDoH

How to finance SDoH initiatives for children, a critical step to their wellbeing and health

Manatt Health, in collaboration with the Robert Wood Johnson Foundation and the Nemours Children’s Health System, released a report outlining how organizations can drive social determinants of health (SDoH) investments for children through a Children’s Health and Wellness Fund.

Revenue & Quality

Biden names picks to lead HHS, CDC

President-elect Joe Biden today announced his nominations and appointments of his health team and the names will be familiar to those in the health care industry.

Population Health & SDoH

Financial and Overall Health are Deeply Connected: How Accurate Data Can Improve Outcomes

Identifying risk attributes — social determinants of health (SDOH) — for populations can enhance an organization’s ability to develop sound, data-driven interventions that can influence change, enrich wellness, and improve profitability.

Population Health & SDoH

SDoH programs aim to address Medicaid members’ social needs

RISE looks at the latest news regarding social determinants of health (SDoH), including recent approaches from Medicaid programs.

Population Health & SDoH

Social determinants in the news: AMA adopts new policies to address SDoH; Cardiovascular death linked to food insecurity; and more

RISE rounds up recent headlines concerning social determinants of health (SDoH).

Population Health & SDoH

COVID-19 escalates opioid epidemic and other addictions, intensifies mental health issues

Research indicates a concerning increase in relapse, fatal and non-fatal overdose, anxiety and depression, and other mental health conditions due to the pandemic.

RISE National

Health Care Futurist Ian Morrison named keynote for RISE National 2021

Morrison will address the future of the health care marketplace, trends, and implications during RISE National 2021, which will take place March 28-30, 2021.

Medicare Market

MA supplemental benefits grew 64% in 2021

A new data brief finds that in 2021 more and more Medicare Advantage (MA) plans will offer supplemental benefits like adult day care services, home-based palliative care, in-home support services, and career support.

Revenue & Quality

Take it from an expert: Fauci’s hierarchy of safety during COVID

In a new interview with Kaiser Health News, the nation's top infectious disease expert breaks down how to survive the coming months and describes how hard it is when people still insist the coronavirus outbreak is “fake news.”

Revenue & Quality

Red states’ case against ACA hinges on whether they were actually harmed by the law

The Republican-led states are trying to prove they were harmed by the 2010 health law—and thus have “legal standing”—because their Medicaid costs increased, even though Congress eliminated the penalty for not having health coverage in 2019. At least one justice was skeptical.

Population Health & SDoH

Social Determinants of … HELP!

While there is not a one-size-fits-all answer to social determinants or social needs, there is some basic information that can help you address the unmet needs of your member population.

Medicaid

CMS offers new flexibilities in final Medicaid, CHIP final rule

The rule puts an end to overly prescriptive regulations that stakeholders have complained about since 2016, according to CMS Administrator Seema Verma.

Population Health & SDoH

2020 Survey of America’s Physicians: COVID-19 Impact Edition results underscore focus on SDoH

The survey explored physicians’ perspectives on the COVID-19 pandemic and the future of the health care system. A key factor: social determinants of health (SDoH).

Revenue & Quality

Justices bound to see ACA as ‘indispensable,’ says Californian leading defense

The U.S. Supreme Court will hear arguments today in a case that could overturn the Affordable Care Act. California Attorney General Xavier Becerra, who is defending the law with the backing of more than 20 other states, told California Healthline that he predicts the justices will uphold it.

Population Health & SDoH

COVID-19 update: Experts warn Trump to take action to stop spike in cases; Biden names members to coronavirus task force; Pfizer offers encouraging news on vaccine

The United States on Monday became the first country to surpass 10 million cases and public health experts warn numbers may continue to climb unless the Trump administration takes steps now to stop the spread of the deadly virus.

Revenue & Quality

What to know as ACA heads to Supreme Court—again

The Supreme Court on Tuesday will hear oral arguments in a case that, for the third time in eight years, could result in the justices striking down the Affordable Care Act (ACA).

Population Health & SDoH

RISE prepares to welcome attendees back to in-person conferences

The RISE team is looking forward to seeing conference attendees live and in person when the time is right. Here are the measures RISE has taken to create a healthier and safer conference experience− let us know when you’re ready.

Population Health & SDoH

SDoH and diabetes: American Diabetes Association unveils scientific review on risks and outcomes

The American Diabetes Association (ADA) conducted a scientific review of previous research and literature on the association of social determinants of health (SDoH) and diabetes risk and outcomes as well as the impact of targeted interventions.

Revenue & Quality

No winner for president yet and health care hangs in the balance

As the votes continue to be counted in the tight battle between President Donald Trump and former Vice President Joe Biden, the federal role in health care is at stake.

Population Health & SDoH

7 strategies to improve care delivery by addressing social determinants of health

Addressing social determinants of health (SDoH) has enabled one special needs plan to improve health outcomes for members and has led to a decrease in emergency room visits, inpatient admissions, and inpatient lengths of stay.

Revenue & Quality

2021 nominations now open for RISE quality award

RISE is now accepting nominations for its annual Martin L. Block Award that recognizes excellence and clinical leaders’ passion to improve patient care. For 2021, RISE has broadened the criteria beyond risk adjustment and Stars to ensure the spirit of excellence and innovation lives on.

Population Health & SDoH

New report proposes to include individuals with social vulnerabilities in first round of COVID-19 vaccine

For the first time, the National Academy of Medicine recommended vaccine prioritization be given to individuals who struggle with social determinants of health (SDoH).

Revenue & Quality

Regulatory roundup: CMS OKs Nebraska Medicaid expansion program; MA plans offer more supplemental benefits in 2021

RISE reviews the latest headlines that impact Medicare, Medicare Advantage, Medicaid, and the Affordable Care Act marketplace.

Medicare Market

Video interview: Kevin Mowll reflects on his tenure at RISE and the future of the association

In this video interview recorded prior to his retirement as executive director of the RISE Association, Kevin Mowll, discusses his work with RISE over the past seven years and what the future holds for the association and its related communities.

Revenue & Quality

Regulatory roundup: CMS expands list of telehealth services for Medicare FFS; Health care policy implications under a newly configured Supreme Court;

RISE looks at recent headlines in the news that impact the health care industry.

Population Health & SDoH

RISE Population Health Summit to feature an interview with four-time U.S. Paralympian Lex Gillette

During the second day of RISE’s live-streamed virtual conference, Gillette will share his firsthand experiences and perspective on health care accessibility.

Population Health & SDoH

Equality Health integrates SDoH efforts in primary care practices to improve care delivery

The health system’s model will enable primary care practices to effectively screen for social determinants of health (SDoH) to improve health equity in vulnerable communities.

Revenue & Quality

Have you checked out the RISE Talent Hub?

Learn more about one of the exciting benefits of joining the RISE Association.

Population Health & SDoH

The COVID “pivot”: How programs to address social drivers of health are responding to and learning from the COVID crisis

The COVID pandemic changed the landscape of the social needs that drive health overnight. Millions of people lost their jobs; millions of people were ordered to stay home. People lost access to food for themselves and their families because they couldn’t afford it, or they couldn’t get to a grocery store. Miles of cars waiting at drive-through food pantries dominated the headlines. People became more isolated and depressed. People’s ability to pay for their housing was jeopardized.

Population Health & SDoH

SDoH partnership: Independence Blue Cross and Signify Health to launch community health network

The new network seeks to break down barriers between clinical and social care to better address member’s socioeconomic needs in the Philadelphia area.

Revenue & Quality

COVID-19 update: Fauci warns 400K Americans may die; Azar reauthorizes public health emergency; NEJM editorial slams Trump’s handling of coronavirus

COVID-19 continues to dominate headlines in the wake of President Trump’s diagnosis and hospitalization. Here’s a roundup of the latest news.

Population Health & SDoH

The unintended consequence of social distancing on older adults

Under normal circumstances, an older adult is treated every 11 seconds in an emergency department (ED) because of a fall.

Population Health & SDoH

Trump tests positive for COVID-19 as cases surge in the United States

After downplaying the seriousness of the virus for months, President Donald Trump and the First Lady Melania Trump tested positive for the coronavirus. He is now under quarantine.

Population Health & SDoH

Meet Ellen Fink-Samnick, RISE’s new lead for the SDoH Community

The principal of EFS Supervision Strategies, LLC, will work with the RISE Association to help guide our Social Determinants of Health (SDoH) Community.

RISE National

RISE National 2021 to feature new tracks on digital health care delivery, member experience, and compliance/regulatory updates

Mark your calendars! We are excited to return to Nashville, Tenn. in March for RISE National 2021. Get a first look at the new tracks we’ve already planned for you.

Population Health & SDoH

SDoH in the news amid COVID-19: Loneliness rates double in adults; communities of color suffer disproportionate financial strain; and more

RISE looks at recent headlines concerning social determinants of health (SDoH), including the impact of COVID-19 on Latino, Black, and Native American communities.

Revenue & Quality

Trump’s executive order on preexisting conditions lacks teeth, experts say

President Donald Trump’s executive order says that people with preexisting conditions can get affordable insurance. But it doesn’t explain how.

Revenue & Quality

Regulatory roundup: Trump signs exec order on preexisting conditions; OIG officials weighs in on MA investigations; and more

RISE summarizes the latest headlines that impact Medicare, Medicare Advantage, and Medicaid.

Population Health & SDoH

Geriatric house calls can increase access to care in a COVID world

The innovative model of care saves money, improves patient satisfaction, and may boost Medicare Advantage plan enrollment.

Revenue & Quality

Without Ginsburg, judicial threats to the ACA, reproductive rights heighten

With the death of Justice Ruth Bader Ginsburg, a lawsuit brought by Republican state officials has become the latest existential threat against the federal health law, scheduled for oral arguments at the Supreme Court a week after the general election in November.

Population Health & SDoH

Spotlight on RISE’s upcoming Special Needs Plan Leadership Summit

Learn best practices to improve outcomes for hard to reach and at-risk populations during a live-streamed virtual event on Oct. 27-28.

Population Health & SDoH

Top 5 features of RISE’s Population Health Summit

The live-streaming virtual event will feature two days filled with timely discussion on how to best pivot to the new landscape of population health in a post-pandemic world. The 2nd annual summit will take place November 17-18. Here’s an inside look at some of the speakers and hot topics included in this year’s event.

RISE West

RISE Association Executive Director Kevin Mowll to retire in mid-October

RISE Managing Director Ellen Wofford made the following announcement during RISE West on Friday:

Population Health & SDoH

Study: MA serves beneficiaries with higher social risk factors

A new study released by Better Medicare Alliance (BMA), a leading research and advocacy organization supporting Medicare Advantage, finds that MA beneficiaries have lower incomes, speak English as a second language, are more likely to rent their home, and are reliant on public transit. The findings, BMA said, show MA’s value to underserved populations.

Population Health & SDoH

SDoH case study: 3 takeaways from RISE’s webinar on medical respite innovations

The RISE Association’s webinar series recently featured a case study on a community-based, multi-hospital system medical respite program in Pittsburgh, Pa. that aims to provide care to people experiencing homelessness.

RISE West

Countdown to RISE West 2020: What you need to know to make the most out of your virtual experience

Learn more about the interactive virtual sessions and activities we’ve planned for RISE West 2020, which will take place Sept. 9-11.

Population Health & SDoH

Why Black aging matters, too

Older Blacks are perishing quietly, out of sight, victims of the pandemic and a lifetime of racism and its attendant adverse health effects.

Population Health & SDoH

New survey reveals health care affordability crisis amid COVID-19 pandemic

The Commonwealth Fund recently explored the quality of health coverage for U.S. working-age adults in the first half of 2020. Among the findings: Two in five adults do not have stable health coverage.

RISE West

Video interview: Jefferson Health’s Dr. Stephen Klasko on the pandemic of the future and what the health care delivery landscape will look like

In this 10-minute video with RISE, Stephen Klasko, M.D., MBA, president and chief executive officer, Thomas Jefferson University and Jefferson Health, provides a glimpse into what a global pandemic would look like in 2030 based on what we’ve learned during the COVID-19 public health emergency of 2020.

Medicare Market

5 takeaways about member communications from the second RISE/Engagys COVID-19 response survey

RISE has once again teamed up with Engagys to find out how communications tactics have changed throughout the COVID-19 pandemic. Here are five findings from our most recent survey. Learn more when we discuss the complete results during a one-hour webinar at 1:30 p.m. EST, Wednesday, Sept. 16. The webinar is free to RISE Association members.

RISE West

RISE West 2020 to shine a spotlight on member engagement during new preconference workshop

COVID-19 has made member engagement more important than ever before. In this article, RISE talks to three of the facilitators of RISE West’s upcoming preconference workshop that tackles the need for Medicare Advantage (MA) plans to double down on member engagement in the second half of 2020.

Population Health & SDoH

HHS releases Healthy People 2030 initiative to address public health priorities and challenges

The agency’s most recent 10-year plan aims to prioritize critical public health issues including the COVID-19 pandemic and social determinants of health (SDoH).

Population Health & SDoH

Survey indicates Americans face greater mental health and economic challenges from COVID-19

A recent international survey found people in the United States are struggling more than people in other wealthy nations amid the global pandemic.

RISE West

The long-term effects of COVID-19 on health care: Part 2 of a video interview with John McDonough of the Harvard T.H. Chan School of Public Health

Part 2 of our interview with John E. McDonough, DrPH, MPA, professor of public health practice, Harvard T.H. Chan School of Public Health, who will be a featured speaker at RISE’s upcoming virtual event, RISE West 2020, Sept. 9-11.

Revenue & Quality

Judge blocks Trump’s anti-transgender health care rule one day before it was to take effect

A New York federal judge on Monday stopped the Trump administration from enforcing a new rule that rolls back nondiscrimination protections for transgender patients.

Revenue & Quality

Rolling back the surge: New Cotiviti map helps forecast COVID-19 health risk severity

As COVID-19 cases and deaths surge in several hot spots across the United States, many individuals and organizations continue to ask, “What else can we do to help protect ourselves, our families, our communities, and our nation?”

Revenue & Quality

Measuring the ROI of social determinants of health interventions

Consider the following framework to effectively assess the ROI of SDoH interventions.

Population Health & SDoH

Study: Social determinants of health increase likelihood of stroke among adults below age 75

The findings indicate that adults who experience one or more social determinant of health (SDoH) have an increased risk of stroke.

Revenue & Quality

Researchers warn COVID-19 deaths could spike to 300K in the US

The death toll in the United States may reach nearly 300,000 by December 1, according to new data released Thursday from the Institute for Health Metrics and Evaluation (IHME) at the University of Washington’s School of Medicine.

Population Health & SDoH

America’s Obesity Epidemic Threatens Effectiveness of Any COVID Vaccine

Researchers caution that a COVID-19 vaccine is likely to be less effective in obese adults.

RISE West

RISE West 2020 to shine a spotlight on SDoH cross-sector community paramedic program

Chief Derek Bergsten of the Rockford, Ill. Fire Department talks to RISE ahead of the RISE West virtual summit, where he will share the success of a collaborative social determinants of health (SDoH) program that has reduced emergency department visits, ambulance runs, and hospital admissions.

Population Health & SDoH

What seniors can expect as their new normal in a post-vaccine world

Experts say adults 60 and up must continue to limit exposure in the years to come—even after there is a vaccine for COVID-19.

Population Health & SDoH

COVID-19 disparities derive from racial and ethnic differences in health risk, job characteristics, and household composition

A recent study found racial and ethnic disparities beyond underlying health conditions play a significant role in the disproportionate impact of COVID-19 on communities of color.

RISE West

RISE West 2020 goes virtual: Sneak a peek at this year’s agenda and speakers

The live-streamed virtual event will take place Sept. 9-11 and features presentations from leading experts in risk adjustment, quality performance, documentation, HCC coding practices, member engagement, payer-provider collaboration, and social determinants of health. Take a look at the sessions we’ve planned.

Population Health & SDoH

New CMS data shows the impact of COVID-19 on Medicare beneficiaries

The Centers for Medicare & Medicaid Services (CMS) on Tuesday released its first monthly update of data that reveals the impact of the coronavirus on the Medicare population, including American Indian/Alaskan Native Medicare beneficiaries.

Population Health & SDoH

3 strategies to address unmet social needs in larger patient population

Recent research indicates a hotspotting approach to meet physical, behavioral, and social needs of high-cost patients is too narrow to have a lasting impact.

Revenue & Quality

COVID-19 update: HHS extends public health emergency, takes over hospital data reporting as cases surge

RISE rounds up the latest news on COVID-19.

Population Health & SDoH

NIH project homes in on COVID racial disparities

The pandemic has given the National Institutes of Health an opportunity to show the value of its $1.5 billion “All of Us” research program. A major effort to make the platform’s database representative of America resulted in minorities making up more than half of its more than 270,000 volunteers.

Population Health & SDoH

Communities of color impacted disproportionately by COVID-19 due to social risk factors

Here are five actionable steps that organizations can take to support communities of color hit especially hard by the global pandemic.

Population Health & SDoH

Study finds Black Americans more likely to be hospitalized or die from COVID-19 due to racial disparities

A study from Sutter Health underscores the role race and ethnicity play in how individuals access care and the health outcomes caused by existing inequities.

Population Health & SDoH

Telehealth study: Technology disparities correlate with health disparities

A new study by EmblemHealth, one of the largest nonprofit health insurers in the United States, reveals ownership of electronic devices, access to internet services, and overall lack of technology impinge on access to telehealth.

Population Health & SDoH

5 step approach for payers to improve behavioral health access and quality amid COVID-19

Learn about the actions BlueCross BlueShield of North Carolina (Blue Cross NC) took as part of a payer-based strategy to improve behavioral health access, quality, and efficiency.

Population Health & SDoH

HHS announces $40M initiative to combat COVID-19 in racial, ethnic minority, and vulnerable communities

The U.S. Department of Health & Human Services (HHS) Office of Minority Health (OMH) will partner with Morehouse School of Medicine to help the communities hit hardest by the global pandemic.

Population Health & SDoH

HHS launches MENTAL Health Innovation Challenge to tackle social isolation amid pandemic

The Administration for Community Living (ACL) and the Office of the Assistant Secretary for Health created the challenge to find an online tool to help isolated Americans connect with others and engage in the community.

Population Health & SDoH

Social determinants of health: 3 takeaways from RISE’s virtual summit

Client perspectives call for more action from plans and providers, community-based organizations (CBOs) thrive in cross-sector collaboration, and loneliness and mental wellness remain areas of concern.

Population Health & SDoH

From poverty to Emmy Award winning journalist: How John Quiñones managed to defy the odds

The ABC news veteran shared his inspiring story during a keynote fireside chat at last week’s virtual RISE National Summit on Social Determinants of Health.

Population Health & SDoH

Exclusive insight into the results of RISE’s benchmarking survey on SDoH

The benchmarking survey focused on how health plans and community-based organizations define success for programs that address social determinants of health (SDoH) and measure their outcomes and impact.

Population Health & SDoH

Staggering rate of loneliness identified in Cigna study

The survey examined the occurrence of loneliness among Americans and the link between factors such as age, social media use, income, and occupation.

Population Health & SDoH

Social determinants in the news: Patients postpone care amid pandemic; School closures leave children neglected and hungry; and more

RISE looks at recent news regarding social determinants of health (SDoH), including the different impacts the global pandemic presents to children and adults.

Population Health & SDoH

For seniors, COVID-19 sets off a pandemic of despair

The guidance to stay sheltered as society slowly reopens wears on older Americans, who have a growing sense of isolation and depression.

Population Health & SDoH

Drastic health disparities intensify in communities of color amid COVID-19

The global pandemic has exacerbated existing inequities for the black and Latino populations, putting them at heightened risk for physical and mental health issues.

Population Health & SDoH

RISE virtual seminar series returns: Managing Behavioral & Mental Health During & Post Pandemic

The virtual event on June 4 and June 5. will bring together industry experts to examine the impacts of COVID-19 on vulnerable population and strategies for adaptation in this uncertain time.

Population Health & SDoH

5 reasons to register for RISE’s Virtual National Summit on Social Determinants of Health

Leading experts from cross-sector health care organizations will share insights to address challenges related to social determinants of health (SDoH). If you’re a professional involved with community-based organizations (CBOs), payers, hospitals/health systems, funders, manufacturers or government entities, you’ll want to be a part of this drive for social good.

Population Health & SDoH

7 tips to tackle stress and create resiliency amid COVID-19

While people across the country continue to experience different impacts from the global pandemic, they all have one thing in common: Stress. Here are some tips to build resiliency in these uncertain times.

Population Health & SDoH

New CDC data emphasizes role homelessness plays in COVID-19 spread

A recent report from the Centers for Disease Control and Prevention (CDC) confirms homelessness is a significant contributor to virus spread.

Population Health & SDoH

A simple phone call goes a long way when it comes to loneliness amid coronavirus

Social isolation due to COVID-19 has friends and families left to their own devices…literally. So much so, that grandparents are trying to learn new communication technologies to stay in touch.

Population Health & SDoH

CDC study examines demographics behind coronavirus hospitalizations

The findings indicate that older adults, males, black Americans, and those with underlying health conditions are at a higher risk for hospitalization due to the virus.

Population Health & SDoH

New population health website enables researchers to examine SDoH in California as it relates to COVID-19

The launch of the interactive mapping website, which curates publicly available data at the census tract level, provides an added resource to California-based researchers amidst the COVID pandemic.

Population Health & SDoH

Medicare eligibility expansions could improve existing racial and ethnic health disparities

Several proposals to expand the Medicare program are under consideration. Here’s a breakdown of each approach and what they could mean for those at risk of racial and ethnic health disparities.

Population Health & SDoH

Social distancing may exacerbate loneliness in older adults, putting their health at serious risk

While it’s vital that Americans hunker down at home to avoid spreading COVID-19, doing so may amplify another public health threat: loneliness. Research has shown that loneliness is as damaging to a person’s health as smoking 15 cigarettes per day.

Population Health & SDoH

Select progress on social determinants of health harms other essential safety-net programs

The Department of Health and Human Services (HHS) has implemented efforts to better address social determinants of health (SDoH) for certain programs and groups of people, but others face worsened conditions, according to a Health Affairs blog post.

Population Health & SDoH

Social determinants of health intensify alongside coronavirus

Gaps in the social safety net have become apparent as public health leaders try to halt the spread of the virus.

Population Health & SDoH

Study confirms strong link between socioeconomic status and health for older adults

Mortality rates for low-income older adults who are dually enrolled in Medicare and Medicaid are twice as high compared to those more affluent and solely enrolled in Medicare.

Population Health & SDoH

Social determinants in the news: Social distancing may put those most vulnerable at risk; rural communities more likely to skip preventive care; and more

RISE looks at recent headlines concerning social determinants of health (SDoH), including the impact social distancing has on those already most vulnerable.

Population Health & SDoH

Deft Research report: Social determinants drive ‘convenience use’ of emergency rooms – but not for the reasons you may think

A new blog post from Deft Research looks at the link between non-medical circumstances and the use of the emergency room for non-emergency and routine medical care.

Population Health & SDoH

RISE Nashville, National Summit on Social Determinants of Health postponed to late June 2020

RISE reschedules national conferences due to concerns over COVID-19.

Population Health & SDoH

CMS official to speak at The RISE National Summit on Social Determinants of Health

Speaker update: Calder Lynch from the Center for Medicare & Medicaid Services has been added to a roster of more than 50 speakers at the annual event, March 15-17, 2020 at the Omni Nashville Hotel.

Population Health & SDoH

The National Summit on Social Determinants of Health: CBOs are ready and willing to partner with health systems

Leading experts in the community-based organization (CBO) space will join together for an open panel discussion about firsthand experiences, strength and constraint areas, and bridging the gap between health care partners-a necessity for continued improvement in social determinants of health (SDoH), according to Denise Harlow, chief executive officer, National Community Action Partnership. Harlow will moderate the panel on June 10, the first full day of this year’s virtual summit.

Population Health & SDoH

CMS report reveals the most commonly used codes for social determinants of health

The Centers for Medicare & Medicaid Services (CMS) recently released its first report on the use of diagnostic codes for social determinants of health (SDoH) in Medicare claims since the Z codes were implemented in 2016. The main finding: It’s difficult for the government to capture consistent data because providers aren’t assigning Z codes even when patients reveal their SDoH concerns.

Population Health & SDoH

Despite new doubts, ‘hotspotting’ help for heavy health care users marches on

Gov. Gavin Newsom has earmarked nearly $600 million in his 2020-21 state budget plan to provide intensive care management to high-needs, high-risk patients around the state. The programs are similar to an initiative in Camden, New Jersey, that was called into question by a recent study finding hospital readmissions dropped, but at only about the same rate as patients who didn’t receive the same kind of intensive services.

Population Health & SDoH

RISE Association announces the launch of research project on social determinants of health

RISE Association partners with Mossavar-Rahmani Center for Business and Government at Harvard Kennedy School senior fellow to identify the drivers of successful social determinants of health programs.

Population Health & SDoH

The National Summit on Social Determinants of Health: Jacob Reider, M.D., on the progress made so far with social determinants and what to expect in 2020

Jacob Reider, M.D., chief executive officer, Alliance for Better Health, former deputy national coordinator for health information technology at the U.S. Department of Health and Human Services (HHS), will moderate a fireside chat on the federal government’s plans to address social determinants of health at The RISE National Summit on Social Determinants of Health, which will be held virtually on June 9-11. In this article, Reider shares his thoughts on the value of cross-sector collaboration.

Population Health & SDoH

5 reasons you need to register for The RISE National Summit on Social Determinants of Health

Cross-sector health care organizations will come together in Nashville March 15-17 to address challenges related to social determinants of health (SDoH). If you’re a professional involved with community-based organizations (CBOs), payers, hospitals/health systems, funders, manufacturers or government entities, you’ll want to be a part of this drive for social good.

Population Health & SDoH

RISE recommended reading: Dr. Jacob Reider’s op-ed on payer philanthropy and social determinants of health

Well-intentioned, payer philanthropy is the wrong approach to solving the social determinants of health (SDoH) needs in American communities, writes Jacob Reider, M.D., CEO of Alliance for Better Health, and the former deputy director of the Office of the National Coordinator Health Information Technology, in a piece published by Health Payer Intelligence.

Population Health & SDoH

RISE announces agenda for National Summit on Social Determinants of Health and virtual attendance option

The annual event will take place March 15-17, 2020 at the Omni Nashville Hotel and will feature cross-sectional collaboration as thought leaders discuss actionable, tactical, and scalable solutions to social determinants of health (SDoH). Virtual attendance option is also available for those unable to travel.

Population Health & SDoH

RISE recommended reading: Deft Research’s blog post on social determinants of health and health outcomes

For the latest installment of our semi-regular series that recommends articles, white papers, or issue briefs of importance to RISE members, we turn to a recent blog post by Deft Research’s Richard Hamer, Steve Runfeldt, and Adam Johnson about some of the conclusions from the firm’s survey to measure social determinants of health (SDoH) and intervening factors. These factors, known as “frames of reference” are defined as “internalized concepts and experiences that predict health behavior” and may depend on the person’s upbringing, circle of friends, education, and experiences with health care.

Population Health & SDoH

How to make social determinants of health actionable

With 70 percent of a person’s health attributed to environmental factors and lifestyle choices, it’s crucial to understand what social determinants are and how to apply them to support your population at an individual level.

Population Health & SDoH

RISE recommended reading: United Hospital Fund’s white paper on the social determinants of health

For the fifth installment of our semi-regular series that recommends articles, white papers, or issue briefs of importance to RISE members, we suggest United Hospital Fund of New York’s white paper Complex Construction: A Framework for Building Clinical-Community Partnerships to Address Social Determinants of Health. The paper provides an insightful look into the hurdles that organizations face when they try to leverage the resources of community-based organizations to meet the social determinants of health needs of their patients in a medical setting.

Population Health & SDoH

The National Population Health Summit: Jason Helgerson on trends in population health and the move to value-based payment

Jason Helgerson, chief solutions officer of Helgerson Solutions Group and former Medicaid director for the states of New York and Wisconsin, will be a featured speaker at the National Population Health Summit, Nov. 12-13, in Orlando. In this article, RISE talks to Helgerson and his co-presenter, Juliette Price, solutions architect for the social determinants of health, Helgerson Solutions Group, on trends in value-based payment (VBP), population health, and social determinants of health (SDoH).

Population Health & SDoH

Community health takes center stage at RISE’s inaugural National Population Health Summit

The two-day, dual-tracked event on Nov. 12-13 in Orlando will address the most pressing issues associated with population health, addiction treatment, and disease management.

Population Health & SDoH

Collaboration is key—the biggest takeaway from The National Summit on Social Determinants of Health

WASHINGTON, D.C.—Don’t wait for lawmakers on Capitol Hill to solve problems related to health care. They aren’t going to do it, according to Rich McKeown, the keynote speaker at RISE’s National Summit on Social Determinants of Health. Instead of lawmakers, solutions will come from the 250 attendees of the conference who represent community-based agencies, health plan providers, service providers, and consultants who will drive necessary changes.

Population Health & SDoH

RISE West to take a deep dive into UnitedHealthcare’s housing, wraparound care model that tackles social determinants of health

Speaker Kathleen Stillo, president and chief operating officer of the clinical redesign direct care delivery unit in UnitedHealthcare’s Community & State division, talks to RISE ahead of the September conference about the organization’s mission to provide its most medically and socially complex members with better care at lower cost.

Population Health & SDoH

Social determinants of health: 68% of Americans surveyed have experienced at least one unmet social need in the past year

One-third of Americans say they have trouble meeting their basic human needs, such as stable housing, adequate food, and reliable transportation, and they want health care providers to help identify and address these non-medical social needs, according to the results of a new national survey from Kaiser Permanente. Those who experienced unmet social needs were twice as likely to rate their health as fair or poor compared to those who did not.

Population Health & SDoH

Survey: SDoH tops list of most difficult information to share through HIEs

The health care industry is focusing more attention to the impact that living conditions, lifestyle, and employment have on people’s quality of life and health outcomes. Information collected about these social, economic, and physical conditions, known as the social determinants of health (SDoH), are among the most difficult to share through health information exchanges (HIEs), according to a recent report from eHealth Initiative and Foundation and Orion Health.

Population Health & SDoH

Data collection key to efforts that address social determinants of health

Many health care organizations are establishing programs to address the social needs of their patients and members in response to the growing recognition that personal, social, economic and environmental factors have a greater influence on health status than medical care. RISE looks at some of these efforts, including the Centers for Medicare & Medicaid Services’ data-collection initiatives, and Kaiser Permanente’s rollout of a social health network to address needs on a broad scale.

Population Health & SDoH

Medicare Advantage plans can offer additional telehealth benefits in 2020

Medicare Advantage (MA) plans have another new benefit to offer their members in 2020: telehealth services. The Centers for Medicare & Medicaid Services (CMS) recently announced it has finalized changes that would allow MA beneficiaries to access health care services from places like their homes, rather than require them to go to a health care facility for treatment.

Population Health & SDoH

UnitedHealthcare, American Medical Association push for 23 new ICD-10 codes to address social determinants of health

As the health care industry turns its attention to models that address social barriers that prevent people’s access to better health, two big-name organizations have joined forces to push providers to use data for social determinants of health to improve and simplify how referrals are made to social services.

Population Health & SDoH

The 2020 Final Call Letter and Rate Announcement is out: 5 things you need to know

The Centers for Medicare & Medicaid Services (CMS) on Monday released its final policy and payment updates to Medicare Advantage (MA) and Part D programs for 2020. In addition to updated payment rates, the agency outlined policy changes to address the opioid crisis, star ratings enhancements, and social determinants of health. Here ‘s what you need to know about the Call Letter and payment updates:

Population Health & SDoH

RISE Nashville highlights: Inspiring keynotes, engaging sessions, and networking opportunities galore

NASHVILLE, Tenn.— More than 1,400 executives and senior leaders from hundreds of health plans, provider groups, integrated health systems and service providers across the country came together last week in Nashville to share strategies to address regulatory challenges, the latest trends and developments in the industry, member engagement strategies, and care outcomes.

Population Health & SDoH

Social determinants of health: 5 takeaways from the 2nd annual RISE Symposium

The health care industry’s shift in focus to truly address the social determinants of health is a make it or break it opportunity, according to Jamo Rubin, M.D., founder and CEO of TAVHealth, who served as the chair of last month’s RISE Symposium on Partnering to Address the Social Determinants of Health in Fort Lauderdale. Social determinants left unaddressed or unresolved flow into the health care system as unintended consequences and become health care claims, he said. The two-day symposium highlighted the challenges and successes of organizations that have made progress tackling social determinants, including behavioral health, opioid addiction, housing, and transportation. Here are five takeaways from the conference:

Population Health & SDoH

5 health plan predictions for 2019

Health plan leaders began the year 2019 just as they did in 2018 with uncertainty over the future of the Affordable Care Act (ACA). RISE turned to industry experts for their thoughts on the ACA and what other challenges the industry may face this year. Here are five predictions from Sean Creighton, managing director of the healthcare consulting firm Avalere; John Criswell, CEO of health care data analytics and technology company Pulse8; and John Broderick, M.D., FACEP, CPE, chief clinical officer-East for the risk-based provider group Landmark Health.

Population Health & SDoH

A potential game changer: CMS takes aim at the social determinants of health, may pay for housing, other social services

Alex Azar, secretary of the Department of Health & Human Services, made a surprising announcement earlier this month during a speech at the Hatch Foundation for Civility and Solutions when he said the agency wants to pay for services that address social determinants of health, the root cause of a large portion of U.S. health spending. Azar says social determinants are tied to the agency’s move toward a value-based healthcare system that delivers better outcomes at a lower cost. But will health plans be a part of the equation?

Population Health & SDoH

3 topics that generated the most buzz at RISE West 2018

Social determinants of health was the hottest topic at RISE West 2018, an indication that in the upcoming year health plans will likely pursue models of care that aim to improve the health and quality of life of their members. Speaker Aaron Horsfield, administrative fellow, UPMC Health Plan, predicted that the industry will see rapid change in this area as more plans collaborate with community partners to address the housing and food needs of their patient populations.