Welcome to RISE

Resource Initiative and Society for Education

Welcome to the home of the Resource Initiative and Society for Education (RISE). RISE is the first national association totally dedicated to enabling healthcare professionals to meet the challenges of managed healthcare. We strive to serve our members on four fronts: Networking, Education, Jobs and Industry Intelligence. Please explore our website and the resources it provides. Those wanting to join the association are invited to complete and submit an application. Take a look at the benefits and services of membership. 

Learn More

Log on to Your Rise Account

Forgot your password?
Create an Account

Latest Posts

Is There a Grey Zone in HCC Coding?

In an insurance world where financial underpinnings are tied to risk, the industry tries to create a science of risk assessment (in the generic sense) so they can price against it with confidence. This has worked historically for life insurance, for example, and in the indemnity health insurance markets, as well. But in today’s health care world, there are points of confusion about risk adjustment coding used to calibrate premiums, as in Medicare Advantage, or to redistribute them, as in the health insurance exchanges. When I mention the idea of “areas of grey” in risk adjustment coding, this is not to say that the coders I met are terribly confused. ...
Read More

Is FFS the Benchmark for Coding Accuracy?

Risk adjustment is taking some heat. Approaches pursued by Medicare Advantage Organizations (MAOs) receive criticism voiced by several actors, not the least of which are in governmental oversight. One of the concerns voiced is that there is a significant difference in the amount of diagnostic codes associated with members of MA health plans in comparison with Medicare beneficiaries still in Original Medicare....
Read More

Sponsors

Upcoming Conference

 

The 9th Annual RISE Nashville Summit

In our 9th year, the RISE Nashville Summit has clearly become the premier event for MA plans, commercial plans and providers to share lessons learned and best practices for effectively navigating the evolving landscape of risk adjustment and quality management.

More

Upcoming Webinar

Use CMS Best Practices and Address New NCQA Measures with In-Home Assessments

As the CMS announced, it is imperative for plans to use the full spectrum of information obtained during an in-home visit to revise, develop, or implement comprehensive care plans for affected enrollees. Join us April 7th as Advance Health reviews how we already implemented these best practices for clients, the results seen to date and our learnings.

More

Connect With Us

Copyright © 2014 Resource Initiative & Society for Education. All rights reserved.