About Us

The RISE Association (Resource Initiative & Society for Education) is a national association dedicated to supporting the healthplan and provider organizations involved in the healthcare reform movement, particularly those involved in the government programs markets such as Medicare Parts C & D, Affordable Care Act health insurance exchanges, special needs plans for dually-eligible individuals, Medicaid plans for needy populations, Accountable Care Organizations and MACRA initiatives. 

 

RISE Vision and Mission

To build a community and an educational system that promotes successful careers for professionals who are advancing the Triple Aim of healthcare. RISE provides:

  • A forum to build professional identity and a network of colleagues
  • A platform to capture and share knowledge and insights
  • A venue to develop and share benchmarks and document best practices
  • Career track development support
  • A channel for building alliances, partnerships and affiliations that fulfill the vision

RISE is the first national association totally dedicated to supporting healthcare professionals who aspire to meet the challenges of the emerging landscape of accountable care and healthcare reform. We strive to serve our members on four fronts: Education, Industry Intelligence, Networking and Career Development.

  • Education: Through cutting-edge conferences, webcast presentations, job-specific educational curricula, and industry-driven library resources, RISE provides our members with the crucial information they need to stay ahead of the curve. We also actively apply to industry credentialing organizations to ensure that professionals optimize every opportunity our programs offer to earn CEUs.
  • Industry Intelligence: RISE brings the marketplace to members in a collaboration between technical experts, solutions vendors and expert speakers.
  • Networking: RISE members make valuable connections with other healthcare professionals from across the nation, from every section of the industry. Through meaningful networking opportunities and roundtables, RISE brings together multiple perspectives and facilitates highly interactive discussion between professionals. Members hear the best (and worst) practices directly from their peers, and gain valuable insight into market trends.
  • Career Development: RISE members will have access to support tools, career-oriented curricula and networking to enhance their job skills and career tracks.

Who Should Join:

RISE was designed to bring together healthcare professionals from all industry segments whose job functions are directly impacted by the continuing evolution of accountable healthcare financing and delivery, health care reform developments and emerging topics.

Members include professionals working for:

  • Health Plans
  • Physician Organizations, Medical Groups, IPAs
  • Accountable Care Organizations
  • Management Services Organizations & practice management
  • Hospitals & integrated delivery systems
  • Skilled Nursing, Long Term Care and Chronic Care Facilities
  • Medical homes  
  • Sole proprietors or independent consultants 
  • People who are in transition between jobs that would otherwise qualify them for standard membership

With a range of positions: C-Suite roles, Vice Presidents, Directors, Managers, Supervisors and Professional Staff for

  • Quality assurance / improvement
  • Care Coordination, Medical Management, Population Health
  • HEDIS, Stars, Quality Measurement or  Marketplace/QRS
  • HCC coding & revenue
  • Risk adjustment and financial management
  • Compliance and government relations
  • Medical informatics
  • Network development & management
  • Provider engagement
  • Data analytics
  • Operations, claims, member service, enrollment, billing & reconciliation
  • Physician education & engagement
  • Product development & innovation
  • Medicare marketing & sales
  • Member engagement
  • Health Insurance Exchanges and the new Marketplace products
  • Business development & strategic planning

 

Benefits of Membership:

Healthcare professionals are eligible for Standard Membership with RISE, which grants access to:

  • RISE-exclusive webcasts and educational webinars throughout the year
  • RFP Support for identifying qualified vendor support services and competitive bidding
  • Updates on the development of formal educational courses and career support tool development
  • Priority notification of RISE conferences and webinars

Membership Composition

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Latest Posts

CMS Gives EDPS Transition Some Breathing Room

CMS published the final call letter for 2018 yesterday, April 3, which included a welcome accouncement regarding the transition from RAPS to EDPS-based RAF scores. Citing numerous public comments on the subject, CMS throttled back the speed with which they plan to switch over to an encounter-based methodology. Instead of the blended rates originally contemplated, they announced that the more modest blend of 85% RAPS to 15% EDPS would be used in 2018, allowing more time to improve the reliability of the encounter data methods. While the RISE data collaboration study was not cited, we believe that the educational value of our study, along with our communication and advocacy of a more moderate approach by CMS, contributed to the confidence with which plans and other interested parties spoke up during the open comment period. Once again, we owe thanks to the folks at Avalere and Inovalon, as well as at AHIP, for the collegial and professional collaboration. Also, we want to thank the health plans that actively participated in our study for making this work possible. ...
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Take Aways from RISE Nashville Summit

The 11th Annual RISE Nashville Summit continued the event’s tradition of yearly growth. The return to downtown Nashville was widely applauded by attendees, who were glad to be back near Broadway’s nighttime funk and fun. While festive, this year's event occurred in the wake of the new administration in Washington, D.C., and the healthcare themes surrounding the "repeal and replace" of the Affordable Care Act (ACA) cast a long shadow. In contrast to the upbeat, confident notes struck by last year’s keynote speaker Senator Tom Daschle, this year’s sobering keynote address by Howard Fineman, NBC/MSNBC political analyst, The Huffington Post Media Group global editorial director, and bestselling author, was an assessment of the pluses and minuses of our new president. Mr. Fineman's remarks indicated that the political alliances in power will seek to undo what Senator Daschle viewed as "irreversible” a year ago....
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Upcoming Conference

 

Qualipalooza: The 2nd Annual RISE Quality Leadership Summit 

This unique event incorporates three conferences presented side-by-side: the Star Ratings Strategic Planning Forum, the HEDIS Forum, and the CAHPS, HOS & Member Survey Forum. Register for one conference for an in-depth examination of a single area, or design your own event by opting for the all-access pass and choosing the sessions from each conference which correspond exactly to your interests.

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Upcoming Webinar

The Impact of Quality Incentive Models in Medicaid Markets

 

Thirty-one of our fifty states now have Medicaid managed care, and several markets are expected to implement managed care in the next few years. More than $160B in Medicaid spending occurs through the Managed Care Organizations. As more and more states seek to do more with less, increasing accountability for health quality outcomes is placed on health plans. Join this webinar to learn the typical quality payment approaches states use, issues often faced by health plans under each model and what states are expected to do with payment models tied to quality performance in light of near term Medicaid reform efforts.

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