The 2 nd Annual Risk Adjustment Innovations Forum will take a deep dive into the most relevant content and unprecedented changes affecting Risk Adjustment across all business lines, including Medicare Advantage, Medicaid, ACA, and the exchanges. While the industry is experiencing an influx of regulatory changes, mounting litigation, new and complex coding changes, it is critical, now more than ever, that health plans and providers alike are prepared and adjusting to their new reality. High level education is key. No fluff, no distractions, just comprehensive risk adjustment strategies -- this is not a tradeshow. With a top-notch faculty of industry-leading Health Plans, providers, and innovative solutions providers, this event delivers specific solutions and strategies to transform your Risk Adjustment initiatives and survive in our new reality. Join us February 21-22, 2024, in Tempe, Arizona. You won’t want to miss this event. Specific areas addressed will include:

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    REGULATION, AUDITS, and LITIGATION UPDATES:

  • Preparing for OIG audits, preventative measures, and potential solutions for health plans
  • High risk miscoded diagnosis codes: Common red flags
  • CMS, OIG, DOJ Regulatory Updates, lawsuits, and preventative measures
  • Implementing internal RADV audit strategies
  • Updating policies and procedures for Risk adjustment to keep you in the clear

    • NEW CODING INITIATIVES AND THE FINANCIAL FALLOUT:

  • Mitigation strategies for the V28 model impact
  • What does V28 look like and what can you expect?
  • Concrete steps to successfully transition from V24 to V28
  • Risk Adjustment submission reconciliation, leaks, vulnerabilities, and error correction
  • Top 10 strategies to enhance chart collection, review, and coding

    • DATA & TECHNOLOGY INNOVATIONS:

  • Interoperability/data integration to support risk adjustment initiatives
  • Interoperability in Value Based Contracts
  • Achieving interoperability & bidirectionality between health plans and providers 
  • MORE data to cleanse, review, and curate
  • Using the right technologies: What’s available and reliable?
  • Actual AI and NLP advancements
  • AI and NLP Advancements

    • UNIFIED COLLABORATION BETWEEN RISK ADJUSTMENT AND QUALITY, VBC, AND SDoH:

  • Understanding Value Based Contracts and payment structure 
  • Tangible tactics to impact health equity and improve SDoH
  • Interpreting the data behind SDoH and its impact on risk adjustment
  • Year-round strategies to close the gap between quality and risk adjustment
  • Ensuring interdepartmental communication and data sharing between all areas

    • THE SIGNIFICANCE OF PROPER AND MEANINGFUL PROVIDER EDUCATION:

  • Educating providers on the reason for risk adjustment programs and how proper documentation can affect member outcomes
  • Assessing provider workflow, problematic areas, red flags, and potential bottlenecks
  • Maximizing time and resources for the greatest impact on members
  • Incentive programs that work and those that don’t
  • Signs you’re overburdening your provider and how to effectively lessen the load

Rave Reviews for the
2023 attendees
Advisory Board

A special thanks to the Risk Adjustment Innovations Advisory Board Members for their thoughtful contribution to the program and agenda development.

CareMore Health

Abhishek Mandal, PhD

Senior Consultant Risk Adjustment
UPMC Health Plan

Adele L. Towers, MD, MPH, FACP

Professor of Medicine and Psychiatry, Director, Risk Adjustment
CDPHP

Colleen Gianatasio, MHS, CPC, CPC-P, CPMA,CRC, CPCO, CDEO,CPPM, CCDS-0, CCS, and AAPC Approved Instructor

Director, Clinical Documentation Integrity and Coding Compliance
Paramount Health

Deb Curry, MBA, RHIA, CCS-P, CRC

Director, Risk Adjustment & Recoveries Actuarial Services
Dean Health Plan

Jenna Jansen, CCS, CRC

HCC Risk Adjustment Coder Auditor, SR
Aetna

Jennifer Hayes, DNP, CPC, CRC, CDEO, AAPC Fellow

Lead Director, Quality Management
Network Health

Josh Weisbrod

Vice President Risk Adjustment and Payment Integrity
GRANITE GRC

Khush Singh, MD, MHA, CRC, CPMA, CPCO, CDIP

Director, Risk Adjustment & Value-based Care, Program Operations & Compliance
Southwestern Health Resources (SWHR)

Laura Sheriff, RN, MSN, CPC, CRC

Vice President, Risk Adjustment
Blue Cross of Idaho

Leah Hannum

Director, Government Funding Operations
Moda Health

Michelle Mitchell, MHA, CRC

Director of Risk Adjustment, Corporate
ACHP

Michael Bagel

Associate Vice President of Public Policy
Intermountain Healthcare

Rebecca Welling

Vice President Risk Adjustment
New Vision Healthcare Solutions

Ryan C. Dodson, CRC

Chief Operating Office/Co-Founder
Sentara Healthcare

Scott Weiner

Director, Government Programs
Baylor Scott & White Health

Sunita E. Varghees, MD, PhD, CHCQM

Vice President, System Clinical Documentation Improvement
2024 Advisory Board Members and Speakers
CareMore Health

Abhishek Mandal, PhD

Senior Consultant Risk Adjustment
UPMC Health Plan

Adele L. Towers, MD, MPH, FACP

Professor of Medicine and Psychiatry, Director, Risk Adjustment
BlueCross BlueShield of Minnesota

Andrew Loewer

Director, Quality & Risk Adjustment Analytics
UCSF Health | Office of Population Health

Avi Tutman, MPH, MBA

Manager, Ambulatory Risk Capture
InnovaCare Health

Dr. Carlos Rodriguez, AHCCA

Director of Risk Adjustment
Baylor Scott & White Health

Carrie Horn, MSHA, BBA, RN, CCDS, CCDS-O, CHFP, CRCR, CPC, CRC

Director Outpatient CDI
Attac Consulting

Charles Baker

Vice President, Compliance Solutions
Office of Inspector General

Christopher G. Bresette, CPA

Director, Medicare Part C Audits
CDPHP

Colleen Gianatasio, MHS, CPC, CPC-P, CPMA,CRC, CPCO, CDEO,CPPM, CCDS-0, CCS, and AAPC Approved Instructor

Director, Clinical Documentation Integrity and Coding Compliance
Sentara Health Plans

Dean Ratzlaff

Director – Actuary/Revenue Management
Paramount Health

Deb Curry, MBA, RHIA, CCS-P, CRC

Director, Risk Adjustment & Recoveries Actuarial Services
CareOregon

Dott Campo RHIA, COC, CRC

Senior Risk Adjustment Coding Analyst
BlueCross BlueShield of Minnesota

Jackie Edison, MPP

Director of Program Management, Risk Adjustment, Star, Quality and Risk Adjustment Center of Excellence
Dean Health Plan

Jenna Jansen, CCS, CRC

HCC Risk Adjustment Coder Auditor, SR
Aetna

Jennifer Hayes, DNP, CPC, CRC, CDEO, AAPC Fellow

Lead Director, Quality Management
Network Health

Josh Weisbrod

Vice President Risk Adjustment and Payment Integrity
Ultimate Health Plans, Inc.

Dr. Julio Perez, AHCCA

Director, Medicare Risk Adjustment 
Pareto Intelligence

Kacey Holman

Manager for Risk Adjustment Consulting
Benelynk

Keslie Crichton

Chief Sales Officer 
GRANITE GRC

Khush Singh, MD, MHA, CRC, CPMA, CPCO, CDIP

Director, Risk Adjustment & Value-based Care, Program Operations & Compliance
Southwestern Health Resources (SWHR)

Laura Sheriff, RN, MSN, CPC, CRC

Vice President, Risk Adjustment
Blue Cross of Idaho

Leah Hannum

Director, Government Funding Operations
Corporate Moda Health

Michelle Mitchell, MHA, CRC

Director of Risk Adjustment
Intermountain Healthcare

Rebecca Welling

Vice President Risk Adjustment
New Vision Healthcare Solutions

Ryan C. Dodson, CRC

Chief Operating Office/Co-Founder
Sentara Healthcare

Scott Weiner

Director, Government Programs
Baylor Scott & White Health

Sunita E. Varghees, MD, PhD, CHCQM

VP System Clinical Documentation Improvement
Baylor Scott & White Health

Susan L. Waterman

Director of Risk Adjustment
Providence Health Plan

Wynda Clayton, MS, RHIT

Senior Director Risk Adjustment
Who Should Attend:

This program is designed to appeal to Medicare Advantage, Medicaid, Commercial plans, and the exchanges —Vice Presidents, Directors, Managers, Supervisors and Specialists of:

● Risk Adjustment ● Risk Management ● Risk Revenue ● Revenue Management ● Financial Management ● Actuarial Management  ● HCC Coding  ● Coding ● Encounter Data ● Managed Care ● Performance Improvement ● Quality Improvement (Stars, HEDIS, CAHPs, etc) ● Accountable Care ● Data Management ● Physician/Member Engagement ● Provider/Member Education
2023 Partners
Educational Underwriter
  • Strategic Solutions Network (SSN), based in Boca Raton, FL, is the parent company of the Medicare Risk Adjustment & Revenue Management Management, Plus Quality and Star Ratings and a series of related conferences.
Supporting Organization
  • Strategic Solutions Network (SSN), based in Boca Raton, FL, is the parent company of the Medicare Risk Adjustment & Revenue Management Management, Plus Quality and Star Ratings and a series of related conferences.
  • Strategic Solutions Network (SSN), based in Boca Raton, FL, is the parent company of the Medicare Risk Adjustment & Revenue Management Management, Plus Quality and Star Ratings and a series of related conferences.
  • Strategic Solutions Network (SSN), based in Boca Raton, FL, is the parent company of the Medicare Risk Adjustment & Revenue Management Management, Plus Quality and Star Ratings and a series of related conferences.
Association Partner
  • Strategic Solutions Network (SSN), based in Boca Raton, FL, is the parent company of the Medicare Risk Adjustment & Revenue Management Management, Plus Quality and Star Ratings and a series of related conferences.
Exhibitor
  • Strategic Solutions Network (SSN), based in Boca Raton, FL, is the parent company of the Medicare Risk Adjustment & Revenue Management Management, Plus Quality and Star Ratings and a series of related conferences.
  • Strategic Solutions Network (SSN), based in Boca Raton, FL, is the parent company of the Medicare Risk Adjustment & Revenue Management Management, Plus Quality and Star Ratings and a series of related conferences.
  • Strategic Solutions Network (SSN), based in Boca Raton, FL, is the parent company of the Medicare Risk Adjustment & Revenue Management Management, Plus Quality and Star Ratings and a series of related conferences.
  • Strategic Solutions Network (SSN), based in Boca Raton, FL, is the parent company of the Medicare Risk Adjustment & Revenue Management Management, Plus Quality and Star Ratings and a series of related conferences.
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