RISE Nashville 2015 Hit a Home Run!

What a pleasure to report on last week’s event at the Gaylord Opryland convention center! First, it was the largest event in HEA’s 9 year history featuring RISE. We had over 850 registered in contrast with 600 last year and 450 the year before. Needless to say, we were thrilled with the turnout. Aside from scale, however, what really stood out was the content and speakers in a combination of general sessions (chaired by Nathan Goldstein from Censeo Health) and four concurrent breakout sessions that covered several themes (see below).

  • Joint RISE Advisory Boards Meeting

The joint board meeting concentrated on the strategic outlook for risk adjustment and health plan financial performance. This synthesis of perspectives was a rich discussion that informed us on some of the crucial needs the industry has for the educational programming that RISE is pursuing in concert with HEA and its conference plans. So many new employees and those already on-board are looking to map out careers without adequate foundational preparation nor vehicles for proper skill development. As a response to this, RISE is taking the first step in addressing the needs for risk adjustment disciplines:  the RISE Risk Adjustment Academy. In addition to featuring pre-conference workshops at several HEA conferences coming up, RISE plans to establish some regional workshops for local attendants to drive to without incurring the expense of airfare, hotels and transportation. Please stay tuned for these announcements for fall 2015.

  • Senator Bill Frist – Keynote address

Dr. Frist spoke passionately about the issues of healthcare reform and his expectations that the Supreme Court will decide in favor of the Obama administration in June.

  • Dr. Martin L. Block Award for Innovation & Excellence

Dr. Frist and Kevin Healy from Optum presented the 2015 award to Dr. Jim Taylor from Kaiser Permanente in Colorado. In turn, Dr. Taylor graciously included his team in being the collaborative force in his achievements recognized by RISE with the award.

  • Jeff Grant, CMS

Now firmly ensconced in the Health Insurance Exchange part of CMS, Jeff provided a thorough orientation to the risk adjustment model and fielded several questions from the audience. Jeff invited conference participants to reach out to him with questions and problems they might encounter.

  • Tom Hutchinson

A long time CMS policy expert himself, Tom remains well-connected within the beltway, and shared his sense about the directions that CMS is likely to pursue, particularly in regards to risk adjustment and specific policies around the Medicare Advantage industry.

  • Topic tracks – offered in four simultaneous sessions

    • Medicare Advantage Risk Adjustment
    • Commercial Risk Adjustment
    • Medicaid Risk Adjustment & Case Management
    • Compliance, Audit & Legal
    • Stars and Quality Performance
    • Care Management & Progressive Solutions
    • Risk Adjustment & Quality Data Analytics

The conference was wide-ranging in its topics and featured great speakers. It became difficult to keep track of all the threads and conversations taking place. If nothing else, it proved that, if you cannot afford to get away for any other conferences, RISE Nashville needs to be the one you make sure is in your travel budget!


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Quality measurement and risk adjustment regulations are increasing and the financial impact upon health plans is progressively driving accountability and influencing profitability through payments, penalties, and bonuses. To improve performance and optimize risk and quality payments, Health Plans need to streamline processes, employ best practices for data capture, and focus on strategic interventions that use a member-centric approach.  

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