MAY 22-23, 2017 - FAIRMONT GRAND DEL MAR - SAN DIEGO, CA

2017 SUMMIT HIGHLIGHTS:

AND BACK BY POPULAR DEMAND WITH A NEW AND UPDATED TWIST:

• NEW THIS YEAR – Select between two pre-conference workshops, RADV or Prospective Assessment

• NEW THIS YEAR – Customize your learning experience by selecting between our two tracks

• NEW THIS YEAR – Hear case studies on RADV by the people who actually survived it

• NEW THIS YEAR – Hear the latest on repeal vs. replace• NEW THIS YEAR – Get industry results on RAPS-EDS

data collaboration and its impact on the industry• NEW THIS YEAR – Find out the lessons learned from

the IVA pilot results

• A two-part plan-provider collaboration for improving coding errors and capturing the money you have been leaving behind

• A comprehensive look at capturing, measuring, interpreting, and implementing data analytics

• Best practices for aligning quality and risk adjustment• Tactical strategies to ensure a smooth RAPS-EDS

transition

T O R E G I S T E R : C A L L 8 6 6 - 6 7 6 - 7 6 8 9 O R V I S I T U S A T W W W . H E A L T H C A R E - C O N F E R E N C E S . C O M

THE 10TH ANNUAL RISK ADJUSTMENT FORUM

Two New Additional Pre

Workshops Available this

year!

H E A LT H C A R E E D U C AT I O N A S S O C I AT E S A N D R I S E P R E S E N T

For Medicare Advantage, Medicaid, and Commercial Plans

SPONSORS

Platinum Gold

©

Silver Bronze

pp5 ms 4/24/17

How will plans narrow the gap between risk adjustment and quality? How are plans effectively working with providers to improve coding inaccuracies? What are you doing to improve your risk scores? What are the latest developments with repeal/replace? What lessons can you learn from RADV warriors? How are plans preparing for IVA? Get the answers to these questions and many others by attending our 10th Annual Risk Adjustment Forum slated for May 22-23, 2017 in San Diego. We have expanded the content of the 2017 program by adding two new pre-conference workshops, incorporating two comprehensive tracks, focusing on content-driven topics, and acquiring top industry experts with years of experience and proven results in risk adjustment. Learn from their experience and valuable insight.

Through numerous case studies, debates, lively panel discussions, and intense workshops, you will receive powerful strategies to ignite your marketing, sales, product, and consumer engagement. This is the Medicare event of the year - - do not miss it!

Highlights from the 2017 Summit:• Clear the murky waters of repeal or replace – where do things stand

now?• Comply with risk adjustment rules, regulations, and documentation• Get the actual RADV experience and lessons learned from those

who survived it• Find out how to enhance your accrual process• Collect, measure, interpret, and implement your data analytic

results• Receive tactical steps to ensure a smooth transition from RAPS to

EDS• Interpret the results of the RAPS-EDS data collaboration and how it

will impact your current practices• Walk away with industry best practices for quality and risk

adjustment • Absorb practical plan-provider collaboration tips and significantly

enhance your provider coding results• Hear the latest on IVA results and the valuable lessons learned• Enhance your Medicaid risk adjustment practices

About the Pre-Conference Workshops:Sign up for the optional RADV or Prospective Assessment workshop and maximize the value of this two-day event. The pre-conference workshops are custom-made to dig deeper into each of the categories. To really unearth the intricacies and nuances of RADV or Prospective Assessments this three-hour workshop will delivery everything you need to know by those who have experienced it first-hand. Bonus – it is also the best registration value! Register today! Call 866-676-7689 or online at www.healthcare-conferences.com.

Sincerely,

Laura GarzaLaura Garza, Senior Vice President and Conference DirectorHEALTHCARE EDUCATION ASSOCIATES

P.S. New this year we have added two tracks to deliver everything Risk Adjustment from Medicare, Commercial and Medicaid.

FEATURING CASE STUDIES AND EXPERT PRESENTATIONS BY:

• Colleen Gianatasio CPC, CPC-P, CPMA, CPC-I, CRC, AAPC Fellow Risk Coding and Education Specialist, CDPHP

• David Meyer, Vice President, Risk Adjustment and Encounters, Scan Health Plan

• J. Gabriel McGlamery J.D., Senior HCR Policy Consultant, Florida Blue Center for Health Policy, Florida Blue

• Jenni Monfils, CPC, CRC, Risk Adjustment Compliance Coding Manager, UCARE

• Jessica Smith, Senior Director, Risk Adjustment Solutions, Gorman Health Group

• Jim Corbett, Chief Strategy Officer, Dynamic Healthcare Systems• Scott Stratton, MPH, Chief Data Scientist, Vice President, Product

Analytics, Pulse8• Kim Browning, Executive Vice President, Cognisight, LLC • Kristen Connulty, MBA, Senior Program Manager, Risk Adjustment,

Tufts Health Plan• Megan Lent, MIS, MRA Process Manager, Risk Score Optimization –

Underwriting and Actuarial, Moda Health• Mike Nemeth, Director of Revenue Management Strategy, DST

Health Solutions• Nallu Vijayakumar, Vice President , Performance Programs, Prospect

Medical Systems• Naomi P. Senkeeto, Managing Director, Policy, Blue Cross Blue Shield

Association• Nicole Green, Director, Health Plan Risk Adjustment, Excellus• Paula Sing, HIA, MHP, Senior Director Revenue Program, Florida Blue • RaeAnn Grossman, Chief Sales and Marketing Officer, ArroHealth • Ryan C. Dodson, CRC, Director, Risk Adjustment, First Choice Medical

Group• Tom Nasadoski, MBA, Manager, Risk Adjustment, CDPHP• Walter Simmons, MD, Senior Medical Director, Molina Healthcare• Ana Handshuh, Vice President, Managed Care Programs, Ultimate

Health Plans• Tim Buxton, Director of Coding, Episource • Patrick Coulson, Senior Vice President, Business Development,

Integra ServiceConnect® • Steven Butler, Vice President of Sales, Integra ServiceConnect®• Derek Woo, SVP Strategic Healthcare Informatics, Altegra • Jeff De Los Reyes, Director of Risk Adjustment, Emblem• Alan Chuang, Pharm D; Director, Pharmacy Services & Health

Management, Chinese Community Health Plan

• Customize your learning experience by picking and choosing from two tracks

• Discover how to maximize your quality and risk adjustment results • Get the latest on repeal or replace • Discover what steps to take NOW to improve your risk scores• Get a behind-the-scenes look at an actual RADV audit • Seamlessly transition to EDS: Avoidable mistakes, industry data

collaboration results, and more• Get a one-two punch on plan-provider collaborations for improved

education and results

• Learn how to interpret and implement your data analytics • Select between two pre-conference workshops and maximize your

learning experience – get the value package!• Join hundreds of your colleagues as they share their tricks of the trade

for boosting enrollment for 2017

TOP REASONS TO ATTEND

SPONSORSHIP AND EXHIBIT OPPORTUNITIES

Enhance your marketing efforts through sponsoring a special event or exhibiting your product at this event. We can design custom sponsorship packages tailored to your marketing needs, such as a cocktail reception or a custom-designed networking event.

To learn more about sponsorship opportunities, please contact Kevin Weigel at (704) 341-2448 or kweigel@healthcare-conferences.com

DAY ONE: Monday, May 22, 2017

Optional Pre-Conference Workshop:Prospective Assessments

Optional Pre-Conference Workshop:RADV Master Class

8:30 – 11:30 RADV Survival Strategies: From Selection to Actual Audit and Everything in Between

• Medicare vs. commercial RADV• Financial planning• System experiences with working with CDAT• Provider documentation issues• Provider issues• Managing selection variables• Changes in risk scores• Distribution and volume of HCCs• War stories from the audit: What did you learn?• How would you do things differently?

Tom Nasadoski, MBA, Manager, Risk AdjustmentCDPHP

David Meyer, Vice President, Risk Adjustment and EncountersScan Health Plan

8:30 – 11:30 A Step-By-Step Guide for Improving Prospective Assessments

• How can you improve your prospective assessments to get the most effective results for risk adjustment?

• Optimal design and implementation of prospective assessments• What is the best model for your plan?• Governance and regulation considerations• Overcoming data nuances• Incentivizing providers • Identifying gaps in care• Measuring tangible and intangible ROI

Kristen Connulty, MBA, Senior Program Manager, Risk Adjustment Tufts Health Plan

Patrick Coulson, Senior Vice President, Business DevelopmentIntegra ServiceConnect®

Steven Butler, Vice President of Sales Integra ServiceConnect®

10:30 – 11:30 Registration sponsored by

11:30 –11:35 Co-Chairs’ Opening Remarks:

Chairs TBA

11:35 – 12:30 Opening Address:Adhering to the Changes Made/Proposed by the New Administration: Repeal or Replace Realities

• What’s the latest with the new administration and the repeal or replace status?

• How will the marketplace be restructured?• What will replace look like?• How will it affect risk adjustment?• What’s the latest with guaranteed issue and pre-existing

conditions?

J. Gabriel McGlamery J.D., Senior HCR Policy Consultant, Florida Blue Center for Health PolicyFlorida Blue

Naomi P. Senkeeto, Managing Director, PolicyBlue Cross Blue Shield Association

12:30 – 1:45 Luncheon for all attendees & speakers

1:45 – 2:45 Risk Adjustment Rules, Regulations, Compliance, & Documentation (Covering Your A$$)

• RADV expansion updates• What is happening in the regulatory world and where will

that go?• Compliance review• Chapter 7 updates• What information should you have available to ensure you

are CYA?• High-cost risk pool updates• Bringing re-insurance back?

Naomi P. Senkeeto, Managing Director, PolicyBlue Cross Blue Shield Association

Walter Simmons, MD, Senior Medical Director Molina Healthcare

2:45 – 3:00 Afternoon Break sponsored by

A Two-Part Audit-Preparedness Discussion

3:00 – 4:00 Part I: Survival Case Study: RADV Survival Case Study: This is How We Survived and How We Were Impacted by RADV

• What do the insiders have to say about RADV?• What did they go through?• What did the dooms-day prep consist of?• Process, resource allocations, and what you need in your

survival kit• Results • Contract 11 & 12: was it worth the work?

Tom Nasadoski, MBA, Manager, Risk AdjustmentCDPHP

Jessica Smith, Senior Director, Risk Adjustment SolutionsGorman Health Group

4:00- 4:45 Part II:A Step-By-Step Look at the Accrual Process

• How to take the results of the exercise and accrue for it? • Lessons learned: This is what we did and this is how we

did it • Rationalizing the accrual decisions

Speaker TBA

7:45 – 8:30 Pre-conference Workshop Registration Sponsored by:

7:45 – 8:30 Breakfast Sponsored by:

4:45-5:45 Cocktail Reception Immediately Following Sponsored by

7:45 - 8:30 Breakfast sponsored by

8:30 – 8:45 Recap of Day One

8:45- 9:30 Building an Analytics-Driven Risk Adjustment Operation: How to Do More with Less:

• Embedding analytics into everyday processes to enable data-driven decision making

• How technology can help to automate and streamline the collection of data, identification of gaps, and distribution of actionable information

• Looking at data more holistically to optimize for results

• Using analytics in real-time to improve ROI and remove waste from the risk adjustment process

• Importance of setting up an on-going feedback loop for continuous improvement

Alan Chuang, Pharm D; Director, Pharmacy Services & Health ManagementChinese Community Health Plan

9:30- 9:45 Data Analytics: Critical Performance Requirements for Successfully Measuring, Interpreting, and Using Analytics

• How do analytics keep changing?• Using predictive analytics to identify problem areas or gaps• Data analytics and calculating risk scores

• Which analytical approaches must be considered? • What are the key barriers to adoption and implementation? • Keys to successfully measuring, interpreting, and using your analytics

Megan Lent, MIS, MRA Process Manager, Risk Score Optimization – Underwriting and ActuarialModa Health

Track B:Commercial Risk Adjustment, Medicaid Risk

Adjustment & Provider Relations

Track A:Risk Adjustment:

Medicare Advantage, RAPS/EDS & Retro/Prospective

9:45 –10:30 Part I:Transitioning from RAPS to EDS: Everything You Need to Do for a Successful Transition

• Valid accuracy concerns• How are the EDS data affecting your risk scores? What can you

do to get the most out of your data?• Tactical steps to eliminate errors• Data completeness• Vendor support vs in-house considerations • Post-submission action • Effectively handling data edits, rejections, errors, and

exceptions • Simplifying reversals, voids, and adjustments • Will premiums sink? If so, what steps should be taken

mitigate the impact?

Jim Corbett, Chief Strategy OfficerDynamic Healthcare Systems

Paula Sing, HIA, MHP, Senior Director Revenue Program Florida Blue

9:45 –10:30 IVA Pilot Results: IVA Lessons Learned, Results, and Industry Reactions

• What do the results reveal?• What are likely changes/adaptions due to the results?• How is the industry reacting to these results?• What can you expect moving forward?

Kim Browning, Executive Vice PresidentCognisight, LLC

Tom Nasadoski, MBA, Manager, Risk AdjustmentCDPHP

Jenni Monfils, CPC, CRC, Risk Adjustment Compliance Coding ManagerUCARE

DAY TWO: Tuesday, May 23 2017

10:30-10:45 Morning Break sponsored by

10:45-11:30 Driving Successful Data Aggregation with Compliance Insights and Regulatory Reframing

Due to the Department of Justice focus, we need to rethink data aggregation and the medical record retrieval approach. The goal is to highlight the complete, accurate, and compliant health status of the member with little abrasion to the provider community.

• What are our new objectives in medical record retrieval and how should we now be driving compliance in documentation?

10:45-11:30 Taking a Deeper Dive into Medicaid Risk Adjustment

• What models are used for Medicaid risk adjustments and which states are using them?

• How does it differ from Medicare Advantage? • What is the process for data collection, validation, and

submission for Medicaid RA? • How does one work around the exclusion of supplemental

data gathered through retrospective chart reviews?

12:15 – 1:15 Luncheon sponsored by

11:30 – 12:15 Case Study: Getting the Most Out of Risk Adjustment & Quality: A Collaboration with Star Ratings, HEDIS, and QRS

• Best practices for quality and risk adjustment practices• What are the results in the pilot states?• Does the financial incentive make a big difference when it

comes to quality?• Will all the quality ratings disappear?• What are the latest updates with Star Ratings, HEDIS, and QRS

initiatives?• Cross-departmental practices to unite and reduce errors • How are plans measuring, reporting, and forecasting

performance?

Mike Nemeth, Director of Revenue Management StrategyDST Health Solutions

Megan Lent, MIS, MRA Process Manager, Risk Score Optimization – Underwriting and ActuarialModa Health

Ana Handshuh, Vice President, Managed Care ProgramsUltimate Health Plans

11:30 – 12:15 Part I: Proper Engagement, Education, and Clinical Documentation Improvement

• Working with providers to get properly coded information and better coding outcomes

• How do you continue to get the most out of your provider groups?

• What type of education is mandatory? • Strategies for securing provider buy-in• What skill-sets are necessary for improving reach for RA? And

how can you develop them?• How do you get providers to respond to your training?• Incentives that work• How do you remove barriers from physicians doing the right

thing?

Jenni Monfils, CPC, CRC, Risk Adjustment Compliance Coding ManagerUCARE

Ryan C. Dodson, CRC, Director, Risk Adjustment First Choice Medical Group

Colleen Gianatasio CPC, CPC-P, CPMA, CPC-I, CRC, AAPC FellowRisk Coding and Education SpecialistCDPHP

• What regulations should we be considering?• What should health plans and capitated provider groups

be doing in 2017-2018 as they design their retrospective campaigns and embed risk mitigation steps?

• What are some solutions for risk mitigation?• Suspect design• Claims validation• Education

• What next steps and hints can be useful in risk mitigation for prospective strategies?

David Meyer, Vice President, Risk Adjustment and EncountersScan Health Plan

RaeAnn Grossman, Chief Sales and Marketing OfficerArroHealth

• What considerations should be made for performing in-home assessments with Medicaid populations?

Scott Stratton, MPH, Chief Data Scientist, Vice President, Product AnalyticsPulse8

Speaker TBA

“Fresh new, best practices, lessons learned, process, industry insight”

Jenni Monfils, UCare

1:15 – 2:00 “Get it right, first time”: Different Methods and Tools to Help the Providers Avoid Mistakes

• Electronic gap closure forms (eGCF) (via iCE or iO)• Prospective outreach• Provider engagement• Clinical review of medical records

Speaker TBAIndegene Healthcare

1:15 – 2:00 Part II:STOP LEAVING MONEY ON THE TABLE: How Much Are You Losing from Improper Coding and How Can You Stop the Bleeding?

• Showing doctors how to arrange their scores• Views from coding and data-mining perspective• Does working with doctors on coding trump analytic results? • Setting a dollar amount to the documentation mistakes

Ryan C. Dodson, CRC, Director, Risk Adjustment First Choice Medical Group

Walter Simmons, MD, Senior Medical Director Molina Healthcare

“Excellent! Knowledgeable speakers – stayed on subject, gave real examples

and experience of Radv, content of topics, gave valid references that will be of use. Case studies and medical coding

discussion very helpful”

Lemay Harkins, AmeriHealth Caritas

2:00 - 2:45 Prospective Assessments: Making the Most of the Live Money • An emphasis on prospective so you still have time – current

and timely• Improving your prospective assessment for better results• How to move past data set-backs

Kristen Connulty, MBA, Senior Program Manager, Risk Adjustment Tufts Health Plan

Tim Buxton, Director of CodingEpisource

2:00 - 2:45 Part III:Integrating Risk Adjustment into the Provider’s Workflow

• Case study integrating risk gaps into provider workflow via the EMR

• Motivating providers to respond to risk gap alerts• Provider reporting that moves the revenue needle• Claims system integration to improve diagnosis code data

and reduce chart coding

Derek Woo, SVP Strategic Healthcare InformaticsAltegra

Jeff De Los Reyes, Director of Risk AdjustmentEmblem

Nallu Vijayakumar, Vice President , Performance ProgramsProspect Medical Systems

2:45 End of Conference

Fairmont Grand Del Mar300 Grand Del Mar Ct,San Diego, CA 92130p: (858) 314-2000

We have a block of rooms reserved at a special rate of $249/night. This rate expires on April 30, 2017; although, we expect the block to sell out prior to this date. To receive a room at the negotiated rate book well before the expiration date. Mention the “Risk Adjustment Forum“ when placing your room reservation by phone to receive the negotiated rate. We urge you to book your room early as we expect the block will sell out. Upon sell out of the block room rate and availability will be at the hotel’s discretion. Please call (858) 314-2000 to book your room.

Team Discounts

• Three people will receive 10% off• Four people will receive 15% off• Five people or more will receive 20% off

In order to secure a group discount, all delegates must place their registrations at the same time. Group discounts cannot be issued retroactively. For more information, please contact Whitney Betts at 704-341-2445 or wbetts@healthcare-conferences.com.

Refunds & Cancellations

For information regarding refund, complaint and/or program cancellation policies, please visit our website: www.frallc.com/thefineprint.aspx

Healthcare Education Associates is a division of Financial Research Associates, LLC. HEA is a resource for the healthcare and pharmaceutical

communities to improve their businesses by providing access to timely and focused business information and networking opportunities in topical areas. Offering highly targeted conferences, Healthcare Education Associates positions itself as a preferred resource for executives and managers seeking cutting-edge information on the next wave of business opportunities. Backed with over 26 years of combined conference industry experience, the producers of HEA conferences assist healthcare professionals, actuaries, attorneys, consultants, researchers and government representatives in their professional endeavors. For more information on upcoming events, visit us online: www.healthcare-conferences.com

RISE (Resource Initiative & Society for Education) Vision:

To build a community and an educational system that promotes successful careers for professionals who aim to advance the quality, cost and availability of health care.

RISE (Resource Initiative & Society for Education) Mission:RISE is the first national association totally dedicated to enabling healthcare professionals working in organizations and aspiring to meet the challenges of the emerging landscape of accountable care and health care reform. We strive to serve our members on four fronts: Education, Industry Intelligence, Networking and Career Development. To learn more about RISE and to join, visit us online: www.risehealth.org

THE CONFERENCE ORGANIZERSVENUE DETAILS

This program has the prior approval of AAPC for 13 continuing education hours max (13 for the conference & workshop, and 10 for the conference only). Granting of prior approval in no way constitutes endorsement by AAPC of the program content or the program sponsor. This approval is valid until 4/30/2018.

ArroHealth is the premier provider of risk adjustment and HEDIS services offering a suite of analytics, medical record retrieval and abstraction, data aggregation, risk adjustment coding, along with telehealth and telemedicine solutions. These services are offered on a unique and proprietary technology platform designed for excellence in results, quality and transparency. ArroHealth recognizes the importance of performance excellence and accuracy—by providing the most extensive guarantees in the industry. We focus on our clients and delivering solutions that accurately impact their risk adjustment and HEDIS programs, while offering insights into the health status of their members. In addition, we provide full transparency into all that we do for clients, allowing them to adapt quickly and maximize financial and clinical results. ArroHealth serves several of the top national health plans as well as many regional and local plans and is committed to accuracy, intelligence and impact for clients.

Pulse8 is the only Healthcare Analytics and Technology Company delivering complete visibility into the efficacy of your Risk Adjustment and Quality Management programs. We enable health plans and at-risk providers to achieve the greatest financial impact in the ACA Commercial, Medicare Advantage, and Medicaid markets. By combining advanced analytic methodologies with extensive health plan experience, Pulse8 has developed a suite of uniquely pragmatic solutions that are revolutionizing risk adjustment and quality. Pulse8’s flexible business intelligence tools offer real-time visibility into member and provider activities so our clients can apply the most cost-effective and appropriate interventions for closing gaps in documentation, coding, and quality. For more company information, please contact Scott Filiault at (732) 570-9095, visit us at www.Pulse8.com, or follow us on Twitter @Pulse8News.

Ciox Health facilitates and manages the movement of health information with the industry’s broadest provider network. Through our expertise in release of information, record retrieval, and HIM, we improve the management and exchange of health information by modernizing workflows, facilitating access to clinical data, and improving the accuracy and flow of health information.

Platinum Sponsors

Gold Sponsors

Apixio is the data science company for healthcare. Apixio’s proprietary cognitive computing platform extracts and analyzes clinical data in electronic and PDF health records, generating deep insights into patient health. It feeds these insights into applications such as HCC Profiler which enables fast, comprehensive, and accurate HCC coding review.

Advantmed is a health information management company that helps managed care organizations optimize revenue and improve quality outcomes. Utilizing our Elevate! Healthcare™ platform to deliver and manage integrated products and services, we capture, organize and analyze financial and clinical data so clients can better understand their member populations to improve their quality of care and optimize risk-adjusted revenue. Advantmed delivers the optimal combination of capabilities unique to each client’s objectives, including risk analytics (ELEVATE! Risk Insights™), NCQA-certified HEDIS® Measures software (ELEVATE! Quality Insights™), medical record retrieval, medical record abstraction, risk adjustment coding, compliance and data validation services, member engagement, provider education and professional services. To learn more, please visit: www.advantmed.com

DST Health Solutions, LLC delivers contemporary healthcare technology and service solutions that enable its clients to thrive in a complex, rapidly evolving healthcare market. Supporting commercial, individual, and government-sponsored health plans, health insurance marketplaces, and healthcare providers, DST Health Solutions’ services include enterprise payer platforms, population health management analytics, care management, and business process outsourcing solutions, each designed to assist a company manage the processes, information, and products that directly impact quality outcomes. DST Health Solutions is a wholly-owned subsidiary of DST Systems, Inc. For more information visit www.dsthealthsolutions.com.

Dynamic Healthcare Systems provides enterprise-wide solutions to health plans participating in Medicare Advantage, Managed Medicaid, and Marketplace programs. Dynamic’s solutions help its clients optimize plan revenue and quality through the utilization of Dynamic’s rich analytics that identify areas for potential improvement, help maintain compliance through ongoing enhancements aligned with CMS regulations, and enhance operational efficiency through fully integrated solution utilizing a centralized database and integrated workflows. Headquartered in Irvine, California, the company offers comprehensive software solutions, managed services, and professional services. For more information, visit dynamichealthsys.com or call 949.333.4565.

Episource provides US health plans and other risk adjusting organizations with powerful data analytics, tools, and insights to drive interventions, benefiting patients and providers alike.? Solutions offered include risk adjustment and quality data analytics, medical coding, encounter data submission, and medical chart retrieval.

As a healthcare business services and technology company, Episource is constantly striving to help its clients simplify the complex challenges of the healthcare industry with specialized services, and innovative technology. Headquartered in Los Angeles, the Company has over 1,500 professionals with extensive experience in risk adjustment.

©

Health Fidelity offers the most comprehensive, scalable risk adjustment solution for the value-based care era. Our modern prospective and retrospective RAF approaches combine big data analytics and natural language processing (NLP) technology to extract valuable insights from medical charts for faster and more accurate processing. With a streamlined coding workflow, Health Fidelity empowers risk-bearing organizations with a 360-degree view, allowing them to project, detect, and capture all commensurate member risk, and thereby risk-adjusted payments, to maximize efficiency, compliance, and reimbursement accuracy.

Altegra Health, a Change Healthcare company, provides technology-enabled, next-generation payment solutions using advanced analytics and supporting intervention platforms to enable health plans and other risk-bearing healthcare providers to generate, analyze and submit data needed to successfully manage member care and ensure appropriate reimbursement, allowing them to elevate care quality, optimize financial performance, increase cost transparency, and enhance member experience and engagement.

Cognisight is a leading health care solutions vendor, specializing in risk adjustment services for Medicare Advantage plans, Health Insurance Exchange issuers, PACE/Duals programs, Medicaid Managed Care plans, Accountable Care Organizations, and Independent Practice Associations. We understand all sides of the risk adjustment equation and provide our services to issuers throughout the United States. Our mission is simple: capture the most accurate and complete diagnostic information to help ensure our clients have the best information to care for their members. As risk adjustment experts, we enable our clients to improve the quality of health care they deliver while assuring accurate revenue.

Gorman Health Group, LLC (GHG) is a leading consulting and software solutions firm specializing in government health programs, including Medicare managed care, Medicaid and Health Insurance Exchange opportunities. For nearly 20 years, our unparalleled teams of subject-matter experts, former health plan executives and seasoned healthcare regulators have provided strategic, operational, financial, and clinical services to the industry, across a full spectrum of business needs. Further, our software solutions have continued to place efficient and compliant operations within our client’s reach. Find out more at www.gormanhealthgroup.com.

Indegene Healthcare delivers next generation solutions for payers and providers across Risk Adjustment, Quality Improvement, Population Health Management And Member/Provider Engagement. Indegene Healthcare leverages its significant capabilities across Analytics, Technology, Operational Scale and Medical Expertise to help payers and providers drive better health and business outcomes.

Indegene Healthcare has a strong focus on IP and innovation, with a full portfolio of next generation platforms including HEDIS Pro and STARMAX for Quality Improvement, RiskOptimizer and ProspectiveEnhance for Risk Adjustment, iClinEngager and Ngage for Provider and Member Engagement, and SmartCare, an integrated enterprise analytics platform for population health management.

Integra ServiceConnect finds and engages up to 50% of a health plan’s unable to reach members, dramatically expanding the expected yield from Hierarchical Condition Categories (HCC) coding efforts. Integra also drives member participation in the appropriate care management and quality-enhancing programs. We specialize in finding, engaging and connecting individuals that cannot be reached through conventional outreach. Our teams of specially-trained local community coordinators understand the unique challenges and opportunities presented by engagement of UTR members.

Since 1985, Medical Data Exchange (MDX) has been serving the Healthcare Industry by creating systems that process healthcare fiscal and clinical data. MDX provides a suite of products consisting of MAX II (hospital claims system), AXIS Physician Practice Management, VChart (EHR), AXIS IPA Management (IPA/MSO/TPA management system), HCC Manager (risk adjustment), P4P, and integrated Case Management systems to support hospitals, health plans and physician organizations. Our systematic applications assist healthcare organizations to move toward integrated healthcare data management in order to optimize quality of care and cost-effective models of care management. For more information call MDX Business Development at (562) 256-3800.

Optum is a leading health services and innovation company dedicated to helping make the health system work better for everyone. With more than 100,000 people worldwide, Optum combines technology, data and expertise to improve the delivery, quality and efficiency of health care. Optum uniquely collaborates with all participants in health care, connecting them with a shared focus on creating a healthier world. Hospitals, doctors, pharmacies, employers, health plans, government agencies and life sciences companies rely on Optum services and solutions to solve their most complex challenges and meet the growing needs of the people and communities they serve.

Silver Sponsors

Bronze Sponsors

Gold Sponsors

MAY 22-23, 2017 - FAIRMONT GRAND DEL MAR - SAN DIEGO, CA T O R E G I S T E R : C A L L 8 6 6 - 6 7 6 - 7 6 8 9 O R V I S I T U S A T W W W . H E A L T H C A R E - C O N F E R E N C E S . C O M

THE 10TH ANNUAL RISK ADJUSTMENT FORUM

Two New Additional Pre

Workshops Available this

year!

For Medicare Advantage, Medicaid, and Commercial Plans

HEALTHCARE EDUCATION ASSOCIATES200 WASHINGTON ST. SUITE 201SANTA CRUZ, CA 95060

THE 10TH ANNUAL RISK ADJUSTMENT FORUM

ATTENTION MAILROOM:If undeliverable, please forward to the Government Programs Director or Medicaid Director

BHv5_2-21

INCORRECT MAILING INFORMATION: If you are receiving multiple mailings, have updated information or would like to be removed from our database, please fax our database team at 704-341-2641 or call 704-341-2387. Please keep in mind that amendments can take up to 8 weeks. Conference Code: H414

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___RADV workshop or ____Prospective Assessment workshop