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.

Keynotes that will inspire you

Former Navy SEAL Brent Gleeson kicks off the main conference on Thursday, Sept. 10 with a keynote presentation on how to lead during times of crisis. Gleeson, an expert on leadership, culture, and engagement, will compare stories from the battlefield, lessons learned, and how to apply those lessons during times of crisis, like the current COVID-19 pandemic.


Marc Milstein, Ph.D., scientist and researcher on health and happiness, will open the second day of the conference with an address focused on how to optimize your brain so you can sleep better, manage stress, boost your memory, and protect your mental health. Dr. Milstein will help attendees tap into the latest breakthroughs in science to live a healthier, happier life.


Stephen Klasko, M.D., MBA, president and CEO, Thomas Jefferson University and Jefferson Health, will close out the conference on Friday, Sept. 11 with a presentation on how COVID-19 will change the health care delivery landscape. He’ll provide tips for payers and providers to navigate the changes in the industry and prepare for the future and will also offer tactical ways to redefine roles within the health care system to provide “best in class patient care.”


General sessions on today’s most pressing concerns

Worried about the outcome of the 2020 election and its effect on Medicare, Medicare Advantage, Medicaid, and the Affordable Care Act? Former politician John E. McDonough, DrPh, MPA, professor of public health practice, Harvard T.H. Chan School of Public Health, will give his predictions and potential scenarios for health plans. McDonough, former member of the Massachusetts House of Representatives, and former senior advisor on national health reform for the U.S. Senate Committee on Health, will discuss the effect of COVID-19 on health care policy, the long-term view of the health care infrastructure and health care policy, and pandemic preparedness.

UPDATE: The 2020 election’s impact on health care: Part 1 of a video interview with John McDonough of the Harvard T.H. Chan School of Public Health

An all-star payer panel will provide a perspective on the shortened calendar year, including what the pandemic means for 2021 risk and quality scores and how the lack of documentation (because of COVID-related seclusions) could adversely impact risk adjustment next year. Panelists will include Mark Dodge, AVP of Stars, risk, and quality, Bright Health Plan, Tom Lutzow, president and CEO, Independent Care Health Plan, and Jason McDaniel, vice president of risk adjustment and quality, Healthcare Partners Nevada.

UPDATE: NCQA Q&A session added to RISE West 2020

It is possible to create a successful cross-sector collaboration to address social determinants of health (SDoH). You’ll learn how the Rockford, Ill. fire department did so through a partnership with health care stakeholders to improve patient outcomes in the community. Chief Derek Bergsten, chief fire officer and chief EMS officer for the Rockford Fire Department, will discuss what led to the success of his partnership with MCOs and hospital systems to optimize emergency medical services in the community.

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

Get insights into what members really think about Medicare and Medicare Advantage (MA) products during a panel discussion with Medicare and MA customers. Engagys Managing Director Kathleen Ellmore will moderate the discussion to learn more about their experience, satisfaction, pros and cons of products, the effects of COVID-19 on their experience, and how they responded to their health plans’ efforts to retain them this year.

Join the RISE Risk Adjustment Policy Committee for a roundtable discussion on the regulatory state of the industry. Panelists will offer their perspectives on real-world implications of telehealth guidance, pending Star ratings changes, and advice on how to stay compliant in an uncertain environment. Speakers include Sean Creighton, vice president of federal policy, Humana; Larry Bishoff, president, Laurence Bishoff & Associates; Dave Meyer, vice president, risk adjustment and quality, Cigna; J. Gabriel McGlamery, J.D., senior health care policy consultant; and Howard Weiss, associate vice president, policy, EmblemHealth.

Concurrent track sessions on main conference days

Each day of the main conference will feature several hours of concurrent sessions in two tracks. Interested in two sessions taking place at the same time? No worries. Our virtual sessions will be available to you for 90 days after the live event so you can watch presentations you missed and re-watch ones you want to hear again.

Sessions in the risk adjustment and quality track will include navigating the new post-pandemic world of risk adjustment and quality; provider/payer collaboration; how COVID-19 is affecting your quality engagement scores; and a case study that spotlights a successful partnership between a payer and their primary care providers.

A track on innovations and responses to COVID-19 will include presentations on risk adjustment in the new era of telehealth as well as telehealth coding guidance in RADV audits.

COVID-19 has also exposed health disparities in the United States. Anna Wetherbee, MBA, principal, technology innovation and integration, Blue Shield of CA, will present a case study during one of the track sessions on the second day on how to tap into SDoH data to advance health equity efforts. She’ll describe how her plan is leveraging novel sources of data to advance SDoH efforts, provide insights into the operational challenges, success and outcomes, of a pilot project that focused on a longitudinal patient record, and share the results from pilot projects.

Take advantage of pre-conference workshops on Wednesday

Back by popular demand! Our in-depth workshop on HCC Coding 201 will provide managers with best practices for an end-to-end method of aligning chart documentation, HCC code chapter, and audit readiness at both the provider and health plan levels. Donna Malone, CPC, CRC, senior manager of enterprise risk adjustment, HCC coding and quality assurance for Tufts Health Plan, and Colleen Gianatasio, director of ambulatory clinical documentation quality improvement, Mount Sinai Health System, will lead the six-hour workshop.

New this year is a workshop on member engagement. The three-hour workshop will focus on tools to keep up with changing quality guidelines for health plans, including the change of CAHPs survey scores, CAHPS improvement strategies, telehealth member experience, and strategies to tackle the second wave of COVID-19.  Speakers include Shannon Decker, M.Ed., MBA, Ph.D., vice president, clinical performance, Brown & Toland Physicians; and Dominic Henriques, vice president of performance improvement and Johanna Martinez, director of quality improvement, both from Prominence Health Plan.

Our risk adjustment professional advance workshop is an update to RISE’s 101 workshop and is designed for those who have a managerial role in risk adjustment, from running the department to the day-to-day duties, with a primary focus on risk adjustment for the Medicare Advantage line of business. Laura Sheriff, R.N., MSN, CPC, CRC, national director, risk adjustment, Molina Healthcare, Inc., and Susan Waterman, RHIT,CCS, CPC ,CRC, director of risk adjustment, Scott and White Health Plan, will serve as instructors of the three-hour class.

Bonus session and network opportunities

Give your mind a rest and join us Friday morning for our bonus “virtual yoga and meditation session” before the opening keynote. Yoga veteran Kim Larkin will guide attendees through breathing exercises, meditation, and gentle yoga to get your morning off to a great start.

We may be virtual, but that doesn’t mean you won’t have a chance to meet with other attendees, exhibitors, and our sponsors. Networking breaks will take place in between select sessions and we’ve also scheduled enhanced networking time in the exhibit hall on both days of the main conference so you can mix and mingle with solution providers and peers to learn the latest and greatest advancements in risk adjustment and quality program improvement.

Click here to learn more about RISE West 2020 and to register for the pre-conference workshops and main conference.