This year’s in-person event will include a focus on the impact of RADV audit strategies, compliance updates, and an entire track on ACA risk adjustment.

Recent whistleblower accusations, the CMS Final Notice, interoperability, RADV audits, and ACA risk adjustment will be among the topics covered at the 19th Risk Adjustment Forum, which will take place May 10-11, with preconference workshops on May 9, at the Fairmont Chicago, Millennium Park.

Day one sessions

The main conference will kick off on Tuesday, May 10 with a keynote panel that will explore fraud, waste, and abuse in the health care industry. Discussion will include recent whistleblower accusations that have resulted in investigations by the Department of Justice and Office of Inspector General and how they impact the risk adjustment space. Panelists include Mary A. Inman, partner, Constantine Cannon, and Wilson Gabbard, vice president, risk adjustment, Advocate Aurora Health.

General sessions will focus on how to maximize interoperability within your risk adjustment program; leveraging prospective risk adjustment solutions for long-term value-based care success; and ensuring accuracy and compliance for membership risk profiles.

The first day will also include two tracks on ACA risk adjustment and technology coding solutions:

  • ACA risk adjustment track sessions will focus on ACA transfer payment trends, ACA data, and the differences between ACA and Medicare audits.
  • The technology coding solutions track will feature sessions on data retrieval, capturing codes missed by NLP, and the value of the concurrent coding.\

The Risk Adjustment Forum

Day two sessions

The second day will open with a keynote address that examines the CMS Final Benefit and Payment Parameters for 2023 and policy changes that impact risk adjustment. J. Gabriel McGlamery J.D., senior health policy consultant, government relations, Florida Blue, will moderate a panel on changes to the weighted approach for the adult and child models, HCC codes that impact risk adjustment, refinements to RADV audits, and changes to telehealth during the pandemic.

General sessions will uncover strategies to improve teamwork among risk, quality, and care management teams; and changes to care delivery and its impact on risk adjustment.

Tracks for the second day will focus on strategies for audit success and risk adjustment compliance improvement:

  • Strategies for audit success track sessions will include audit best practices and a focus on internal and external audits.
  • Risk adjustment compliance improvement track sessions will offer strategies to improve compliance in clinical documentation and compliance responsibilities of risk adjustment professionals.

The 19th Risk Adjustment Forum will take place May 10-11 at the Fairmont Chicago, Millennium Park.  Full-day preconference workshops on risk adjustment and HCC coding accuracy will take place on Monday, May 9. Proof of COVID-19 vaccination is required to attend the conference. Click here for more information about speakers, sessions, how to register, and our health and safety protocols.