RISE Nashville 2014 Recap

The annual RISE conference in Nashville was attended by more than 600 people, about 50% more than last year, and garnered a lot of praise as a valuable and productive event. Healthcare Education Associates is still combing over the evaluations and the feedback to tease out all the comments and suggestions, but it is clear it was a big hit.

What is driving this big upswing in attendance?  Why the surge over last year? The previous year also witnessed a big year-over-year boost, as well. Of course, HEA puts on a top notch program and it runs very nicely, so I do not want to minimize that. But there is more driving it than that. 

I believe the extra factor is the intensified threats and risks that are impressed on the Medicare Advantage market, added to the larger currents of the national health reform movement. We have multiple currents simultaneously moving and converging on the way healthcare is being financed and delivered, placing demands on us all for accountability to achieve what has eluded our healthcare industry for decades. Fair or not, it is what it is, and people came to the RISE Nashville summit to:

  • Learn about the changes in CMS risk adjustment
  • Understand how the Health Insurance Exchanges are unfolding and what the implications are
  • Pick up the tips and insights from best practice presentations
  • Get nuggets on how the plans are navigating the sunset of the Stars demo
  • Numerous other objectives

It is clear that 2015 is going to be a tough revenue year for the Med Advantage world. Not only are we seeing the planned phase-down of payment rates, ratcheting down versus Original FFS Medicare, but a lot of simultaneous factors are combining to whammy the industry at the same time. There is the sun setting of the Medicare Stars demo that will whack even the 4 and 5 star plans in 2015. The insurer fee steps up and further shrinks net revenues. But CMS is proposing to curb the use of the in-home assessment approach to risk score accuracy, which has previously been a useful tool helping to overcome the ever-eroding effect of the intensity adjustment in the annual payment model. 

It is also clear that, as CMS shifts from RAPS methodology to encounter data for risk adjustment. This is promising to have a corrosive impact on payment rates. Some health plans approached RISE for some help in forming a collaboration with RISE Sponsors to demonstrate this effect to CMS. We are keen on garnering RISE member support in this effort. 

Additionally, I noticed something beyond these formal conference objectives.  It was the networking and informal connectivity taking place, a parallel agenda that people had for extracting value from their experience at the conference.  People tell me that they value the content of the conference itself, but they are also hungry for opportunities to connect with peers at other health plans or provider groups to share and compare notes and experience. This is one of the key RISE mission goals: to support and promote networking for our members. The “nuggets” taken home after the conference include these valuable contacts, shaping up the way the virtual community becomes a vital part of the fabric of a learning community. 

I got a lot of great reactions to the announcements I made regarding the RISE programs, which is very exciting and reaffirming:

  • New Website / Relaunch
    • Transition from RA Society website to new www.RISEHealth.org
    • New look and feel, cleaner and more contemporary, easier to navigate
    • Compatibility with mobile apps
    • Member application functionality added
      • Standard membership (employed by healthplans or providers) is complementary
      • RFP Initiative to support vendor shopping
        • Created web functionality to accept RISE members submitting RFP to RISE
        • RISE circulates RFP to sponsors for bidding on business
        • RISE members because they can get more qualified bidders
        • Job Board
          • Anyone can post jobs on RISE Health
          • Only RISE members can see posting and reply
          • Webinar pipeline – sponsors speak, RISE produces event, markets event and registers people
            • 2014 calendar of events set with 30 events
            • First 40 RISE members registering get complementary passes

These are exciting yet difficult times. Driving accountable care and participating in healthcare reform is sometimes a messy and stressful business. It is also a great time to pull together as a community of professionals doing this work, and RISE is prepared to support you all as you strive to RISE to the occasion. 


Log on to Your Rise Account

Forgot your password?
Create an Account

Sponsors

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. ...
Read More

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....
Read More

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.

More

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.

More

Connect With Us

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