In this article we look at the RISE West 2022 sessions planned as part of the Quality track and the Intersection of Risk Adjustment Quality, and Population Health track, two of the scheduled tracks to take place at the annual RISE West conference, September 1-2, in Los Angeles.

We previously previewed the Risk Adjustment Track. Upcoming articles will focus on the other tracks: Compliance/regulatory updates and payer/provider alignment.


Quality track: Thursday, September 1


CMS Star ratings changes

Daniel Weaver, EVP, product operations and Stars strategy, NationsBenefits, will moderate a panel discussion on Star ratings changes that impacted measurement year 2022 and the changes coming to the program in measurement year 2023. The panel will also examine CMS’ expectations for health places to use digital engagement and activation in CAHPS reporting and care gap closure strategies. Panelists include Eden Encarnacion, MHA, director, quality and Stars program, Clever Care Health Plan; Ally Thomas, Ph.D., AVP, quality improvement, UPMC Health Plan; and Carmela Costiniuk, MHA, vice president of population health and clinical transformation, Catholic Medical Partners.

At-home diagnostics

In this session, attendees will learn how at-home diagnostics can raise the score for quality and member satisfaction. Speakers Marc Rothman, M.D., chief medical officer, Signify Health, and Dona Doran, program director risk adjustment operations, Cambia Health Solutions, will discuss how the home serves as a critical and convenient hub for the continuum of care, from annual health evaluations to integrated preventive screening and diagnostic tests that, when coupled with advanced analytics, can detect chronic conditions such as cancer, hypertension, diabetes, and COPD. Discover how health plans can engage at-risk members while driving down avoidable utilization and boosting quality performance safely and effectively

Quality and the member experience

Learn how to a deliver first-class member experience in this session with speakers Ashley Tyrner, founder and CEO. FarmboxRx and Lauren Barca, MHA, BSN, RN, executive officer, population health & quality, UnitedHealthcare Community Plan of Tennessee. They’ll explain how to
integrate an innovative cohesive culture of quality awareness across an organization to drive member satisfaction and internal buy-in of quality programs and initiatives. Tyrner and Barca will also discuss how to design intentional programs that address quality outcomes and social determinants of health as well as how to create partnerships with organizations aligned in health equity initiatives to yield stronger programmatic outcomes, move the needle on quality improvement, and deliver first-class member experience.

HEDIS care gap closures and member experience

This case study session will explain how to work together to revolutionize HEDIS care gap closures and the member experience. Speakers, including Katharine Iskrant, founder and practice lead, Healthy People will examine trends in Stars quality Improvement and the need to explore new care models to remain relevant among members, and to stay competitive among industry players. Julianne Eckert, director of quality improvement, Clover Health, and Archana Mahimkar, MS, MBA, CPHQ, senior director, clinical quality improvement and safety, Walgreens Health, will present a case study on how Clover Health and Walgreens partnered to meet members where they are to orchestrate better outcomes while hitting HEDIS, HOS, CAHPS and member experience measures. 

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Intersection of Risk Adjustment Quality, and Population Health track: Friday, September 2

Kaiser Permanente’s efforts to address SDoH

Join Anand Shah, M.D., MS, vice president of social health, Kaiser Permanente will present a case study that provides insights into Kaiser Permanente’s investment in addressing social determinants of health (SDoH) across all lines of business. Shah will discuss the intersection of ROI with a focus on the connection to Star ratings and HCC coding and how leaders justify their investment in this space. Attendees will also learn about the various tools used on the journey to health equity.

Aligning quality metrics with public health goals

This case study will focus on the COVID-19 vaccine journey within Los Angeles County, with insights in what it took to get over 90 percent of seniors 65+ to receive two doses and nearly 70 percent to get boosted. Speaker Tracey Veal, DrPHA, MBA, senior advisory consultant, LA County Public Health Department, will discuss the collaboration among the public health department, local health systems, community organizations, and payers. Veal will also discuss the connection to health plan quality metrics and overall immunization efforts.

Z code reimbursement

Ellen Fink-Samnick, chair of the RISE SDoH Community, will provide an overview of the Z code landscape and the progress that industry groups, such as the Gravity Project, have made and the impact on plans and providers. She’ll discuss what providers and plans can do to solve for the disconnect between Z code reimbursement and use.

RISE West 2022 will take place September 1-2, with preconference workshops on August 31, at the InterContinental Los Angeles Downtown. Proof of a negative COVID-19 test, or proof of vaccination is required to attend the live event. Click here for the complete agenda, roster of speakers, registration information, and our health and safety protocols.