Rise

Join us for interactive roundtables featuring the latest technologies and solutions for boosting your organization's risk and quality endeavours. These speed-networking type presentations are 20 minutes long, allowing you to make your way to several roundtables per session.

Don't forget to pick up a roundtable passport at the registration desk and visit four roundtables to be entered into a drawing; 100 participants will receive complimentary Maui Jim sunglasses! Sunglasses only available for eligible health plan and health care provider participants (no vendors). 

THURSDAY AFTERNOON ROUNDTABLE TOPICS

Thursday, September 12
4:25pm - 5:25pm
Exhibit Hall

Jump to Friday Morning Roundtable Topics  

Roundtable 1 with Inovalon

Streamlining Medical Record Review with Natural Language Processing

• How health plans can reduce manual record reviews by up to 50%
• How Inovalon’s extensive datasets minimize false positives
• How health plans can implement automation in risk adjustment

Roundtable 2 with Apixio

Enhancing Payer-Provider Collaboration Through Prospective Risk Adjustment

• Evaluate and close diagnosis gaps collaboratively across structured and unstructured data.
• Access complete patient health profiles together to identify diagnosis gaps
• Integrate clinical insights directly into EHR workflows to improve care coordination

Roundtable 3 with ECLAT

Bridging the gap between payer and providers

• Improve documentation experience with seamless integrated EMR tools to improve documentation and code capture process.
• Utilize NLP / ML to compare claims to retrospective reviews for additions and deletions
• Discover strong compliance and validation capabilities to mitigate risks and enhance efficiency

Roundtable 4 with Optum

Care delivery workflow innovations for value-based care success

• Assess the administrative capabilities and levels of digital integration within provider practices to enhance and streamline workflow processes.
• Understand the need to rethink workflows to ensure they effectively serve patients at every care touchpoint.
• Apply best practice methods to enhance collaboration between payers and providers, fostering the success of value-based care.

Roundtable 5 with SecondWave Delivery Systems

The Power of Combining Technology and Human-Driven Services

• The keys to an effective risk adjustment program
• How to accurately and compliantly improve risk scores and associated reimbursement and how to influence positive movement in HEDIS and STAR ratings
• Why provider engagement is a critical component of any risk adjustment program and the importance of focusing on compliance and security

Roundtable 6 with Reveleer

Designing the Future of Risk Adjustment – Innovation and Best Practices

• Balanced Risk Adjustment Programs: Emphasize the need for a well-rounded approach to risk adjustment, incorporating prospective, year-round, and retrospective strategies to ensure comprehensive coverage and accuracy.
• Patient-Centered Care and Compliance: Highlight the importance of maintaining a strong focus on patient-centered care, while ensuring compliance and program integrity to achieve optimal outcomes.
• Leveraging Digital Data and AI: Discuss the growing significance of digital sources of clinical data and the efficiencies that AI can offer in enhancing risk adjustment processes and improving overall program performance.

Roundtable 7 with Mobe

Bend the Cost Curve Down: See How a Health Plan Cut $35M in Projected Spend

• Learn how MOBE’s innovative solution helps solve health plan cost reduction targets through lower claims costs with a guaranteed ROI.
• Explore a unique methodology for identifying and engaging hidden populations using predictive and advanced data analytics focused on member behaviors rather than cost, risk, or diagnosis.
• Hear how MOBE's partnership with a top health plan cut projected costs by $35M and advanced health equity by addressing disparities and amplified engagement.

Roundtable 8 with Summus

Doctor Led Clinical Guidance and Navigation: Driving better outcomes, engagement and satisfaction for members and providers

• Enhancing Quality: Explore hoe doctor led guidance ensures personalized care, leading to improved outcomes
• Boosting Engagement and Satisfaction: Understand the role of doctor led navigation in empowering members to make informed decisions, resulting in higher engagement rates and increased satisfaction
• Streamlining Provider Workflows: Discuss how peer-to-peer interactions can optimize care pathways, reduce burdens on providers, improve efficiency, and allow more focus on member care.

Roundtable 9 with RAAPID

Increase accuracy and compliance in risk adjustment with RAAPID’s AI-driven platform

• Caring for caregivers with proven AI-driven prospective previsit, point-of-care, and post-visit audit across the care continuum.
• Stratify and Prioritize with Precision Targeting for Maximum ROI
• Enhancing Coding Accuracy and Mitigating Audit Risk with AI-Driven Retrospective Review

FRIDAY MORNING ROUNDTABLE TOPICS

Friday, September 13
8:00am - 9:00am
Exhibit Hall

Jump to Thursday Afternoon Roundtable Topics  

Roundtable 1 with Edifecs

When the encounter is over, it isn’t over.

• Prospective technology and strategies both payers and providers can deploy to ensure appropriate coding and documentation
• Incorporating a holistic approach to optimal risk adjustment programs
• The regulatory environment over Medicare, Medicaid and ACA risk capture is nuanced, so succeeding in each market requires a unique approach

Roundtable 2 with Arcadia

Meet your Partner in Data – How Arcadia helps solve key risk adjustment pain-points for Payers

• As healthcare systems evolve toward value-based care, risk adjustment has become a crucial tool for payers to ensure fair and equitable financing across diverse populations
• Risk Adjustment comes with it’s set of challenges such as automating chart audits on a large scale, effective risk stratification, manual process reduction, and more
• In this session, we will demonstrate how the Arcadia platform can address and solve these key issues faced by Payers in the Risk Adjustment process.

Roundtable 3 with Evernorth Health Solutions

Improving Polychronic Care

• SOLUTION: We serve high-risk, high-need members who struggle to access healthcare. We bring high-quality primary and preventive care services to the home.
• IMPACT: We address total cost of care, and health inequities, by improving convenience and reducing fragmented healthcare delivery.
• OUTCOMES: We positively impact critical KPI’s (IP and, ER admissions, re-admissions MLR, and NPS) and close gaps in care.

Roundtable 4 with MedOrion

Leveraging AI and Behavioral Science to Enhance Health Outcomes

• Improve Medicare Star Ratings by scientifically understanding your member's barriers at scale
• Target those members with social risk factors in order to maximize the Health Equity Index
• Understand your members' conditions early in the year to improve risk and clinical management

Roundtable 5 with Cozeva (Applied Research Works)

Transforming Chronic Condition Management at the Point of Care

• See the CozevaConnect EHR integration live in action
• Provide real-time feedback directly in the EHR back to providers
• Utilize AI powered population health models to proactively manage patient health outcomes

Roundtable 6 with Signify Health

Doing More in the Home: Health Condition Focused Visits for Better Disease Management

• Members highly satisfied with their In-Home Health Evaluation are 74% more likely to consider additional in-home health services (Signify Health. Health plan member NPS: 73)
• Bespoke solutions are needed for high-prevalence, high-cost health conditions with screening/monitoring/treatment adherence challenges
• Fragmented in-home health care services market creates challenges impacting access, quality, experience and total cost of care

Roundtable 7 with Cognizant

Digital Health Maturity with Operational Excellence

• Discover the strategic value of silo busting and how dismantling organizational silos leads to achieving strategic alignment in value-based healthcare
• Discover how to implement best practices for Electronic Clinical Data Systems (ECDS) reporting to enhance data collection and accuracy from disparate data sources
• Learn how to manage unstructured data and develop innovative solutions for efficient HEDIS and Risk Adjustment chart abstraction. Beyond Natural Language Processing (NLP), to streamline data abstraction and improve accuracy.

Roundtable 8 with Wolters Kluwer

Take Control: Transform Risk Adjustment Coding with an In-House Command Center

• Explore how clinical AI increases coding productivity and accuracy
• Learn about cutting edge technology to respond to RADV audits
• Discover the benefits of bringing your coding projects and coding vendors “in-house”

Roundtable 9 with Biomedix

Coordinating diagnostic and care delivery resources in v28r

• Best Practices in chronic condition diagnostics, care planning, and care delivery
• Best Practices in secure and automated data management with provider EMRs and Insurance Plan business systems

Roundtable 10 with Centauri Health Solutions

"C" How Context and Complexity Affect SDOH Code Capture

• Hear engaging, real-life, deidentified case studies that demonstrate how the encounter complexity and context influence the selection of SDOH codes
• Understand why it is more important than ever to capture codes related to SDOH
• Discuss documentation improvement strategies specific to SDOH to ensure complete and accurate SDOH code capture

Roundtable 11 with Ingenia Health

"Member Experience Unveiled: Transforming Negative Healthcare Moments into Positive Solutions"

• • Explore Real Experiences: Engage in an interactive "Guess Who" activity to identify and discuss common healthcare experiences and their impact on member satisfaction.
• • Explore Measurement Methods: Review how member satisfaction is currently measured and explore a novel approach using existing data.
• • Leverage Innovative Tools: Connect these experiences with our cutting-edge member experience measures to uncover actionable insights and drive meaningful improvements in patient care.

Roundtable 12 with AAPC

Optimizing Patient Outcomes: The Power of Pre-Visit Reviews

• Capture Key Conditions: Identify and address chronic conditions and comorbidities before the visit.
• Reduce Errors: Prevent post-visit corrections with accurate pre-visit coding.
• Ensure Accurate Risk Scores: Accurately reflect the patient’s true health status to ensure appropriate risk assessment.

Roundtable 13 with Kandu Health

Reducing readmissions by over 50% in the first year after acute stroke through Principal Illness Navigation

• • Up to 8% of Medicare enrollees have experienced stroke, with patients in the most expensive states having an average annual total cost of $46,722
• • 25.9% of Medicare Fee For Service beneficiaries experiencing stroke will have a readmission within 90 days of discharge. Most of these readmissions are avoidable.
• • Virtual care is particularly effective in supporting this population due to post-stroke impairments and lack of availability of stroke-specific resources.

Roundtable 14 with Creyos

Unlocking the Potential of CMS-HCC V28 Through Data-Driven Dementia Assessment

• Explore ways to enhance your risk adjustment strategy to address the expansion of dementia HCCs in CMS V28.
• Discover how Creyos's screening and assessment tools drive increased dementia diagnosis rates and detection of mild cognitive impairment for improved RAF scoring.
• Learn how to integrate digital health technologies into your health system with streamlined implementation, provider adoption, and operational efficiency.

Roundtable 15 with Vatica Health

Driving high compliant RA yield through meaningful PCP support and engagement

• Dedicated, ongoing clinical resources to support each PCP.
• Member engagement resources to drive high panel penetration.
• Reduce PCP abrasion by only presenting high confidence conditions and minimizing time spent for coding.