Events

 

The RISE Star Ratings Performance and Analytics Forum

December 5-6 - Las Vegas, NV

With CMS setting high stakes and moving targets for Star Ratings, it is more important than ever to develop a winning Stars game plan that will revamp your operational strategies, enhance your data gathering and analytics execution, and drive your quality goals forward.  Join us for this exceptional two-part program!  

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The Advanced CDAG Mock Audit and MAPD Compliance Summit

December 8-9 - Austin, TX

With an intense focus on the most challenging CMS audit elements, you will get best practices for monitoring your PBM and their downstream entities, administering fully compliant beneficiary notices, learn what critical preparations you should be making in light of the MTM universe pilot, and so much more!

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2nd Annual Medicare Secondary Payer Master Class

January 23-25 - Dallas, TX

Designed for all MSP stakeholders in the Non-Group Health Plan arena, this conference will provide tips and feedback to reinforce best practices for mandatory insurer reporting, conditional payments, and Medicare-Set Asides. Plus, CMS will be joining us to kick off the conference with legislative updates and answer your most challenging MSP questions during a facilitated question & answer panel.

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The Medicare Advantage Bidding Bootcamp

January 23-25 - Dallas, TX

HPMS. BPT. PBP. PBM. NABA.  Are you eager to tackle your plan’s Medicare Advantage bid, but feel like you’re swimming in acronym soup?  Not to mention drowning in the thousands of pages of instructions, templates, workbooks, and notices and call letters of both advance and final varieties?

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Medicare Advantage Accouting and Reconciliation 101 Bootcamp

January 30-31 - Nashville, TN

HPMS. BPT. PBP. PBM. NABA.  Are you eager to tackle your plan’s Medicare Advantage bid, but feel like you’re swimming in acronym soup?  Not to mention drowning in the thousands of pages of instructions, templates, workbooks, and notices and call letters of both advance and final varieties?

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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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