Sponsors

Thank you to our sponsors!

If you are interested in becoming a sponsor for RISE, please contact Kevin Weigel at 704-341-2448 or kweigel@risehealth.org.

Platinum Sponsors

Inovalon is a leading technology company that combines advanced data analytics with highly targeted interventions to achieve meaningful impact in clinical and quality outcomes, utilization, and financial performance across the healthcare landscape. Inovalon ’s unique achievement of value is delivered through the effective progression of Turning Data into Insight, and Insight into Action®. Large proprietary datasets, advanced integration technologies, sophisticated predictive analytics, and deep subject matter expertise deliver a seamless, end-to-end platform of technology and nationwide operations that bring the benefits of big data and large-scale analytics to the point of care. Driven by data, Inovalon uniquely identifies gaps in care, quality, data integrity, and financial performance – while also bringing to bear the unique capabilities to resolve them. Touching more than 540,000 physicians, 220,000 clinical facilities, and more than 140 million Americans, this differentiating combination provides a powerful solution suite that drives high-value impact, improving quality and economics for health plans, ACOs, hospitals, physicians, patients, and researchers.

Verscend Technologies

As healthcare adapts to an aging demographic, new payment models, and the rising cost of care, our clients face increasingly complex clinical and financial risk. Verscend Technologies (formerly Verisk Health) drives better healthcare outcomes through data analytics. Our solutions help organizations organize and optimize their data so they can efficiently and cost-effectively succeed in the new era of healthcare.

We offer an array of solutions that create value across four major functional areas:

 

  • Payment Accuracy: fraud, waste, and abuse solutions that ensure accurate payment and cost containment

 

  • Revenue Integrity: solutions that simplify commercial, Medicare, and Medicaid risk adjustment initiatives and ensure appropriate funding for members and their conditions

 

  • Quality Improvement: end-to-end support for unified quality measurement, reporting, and improvement

 

  • Population Risk Assessment and Stratification: decision analytics, including DxCG risk adjustment models and reporting solutions

 

Verscend has extensive experience helping healthcare payer organizations use their data in meaningful ways. We currently serve than 200 health plans, including regional and national plans with commercial, Medicare, Medicare Advantage, and Medicaid lives. Over more than two decades, we have built a reputation for the knowledge and integrity our team, our ability to organize data for smarter solutions, and our history of delivering quantifiable results.

For more information, please visit www.verscend.com.  

Optum is a health services company with more than 35,000 people dedicated to making the health system work better for everyone. Our solutions and services are used at every point in the health system, from provider selection to diagnosis and treatment, and from network management, administration and payments to the innovation of better medications, therapies and procedures.

Optum helps solve the fundamental challenges facing the health system with unmatched depth and breadth of capabilities, a diverse portfolio of innovative health services and technologies and the exceptional expertise of our people. Our solutions and capabilities:

  • Provide physical and mental health information and services to more than 60 million Americans – helping them and other health organizations navigate the system, finance their health care needs and attain their goals.
  • Improve the performance of the health system with analytics, technology and services that enable better decisions and results.
  • Assist with clinical management and delivery of prescription medications and consumer health products.

Every day, we shape how health care is managed, and how information and technology drives improvements in the system. Optum works with our clients and partners to improve the delivery, quality and cost effectiveness of health care in ways that support and empower more patient-centered, value-driven care.

Pulse8 is a cutting-edge healthcare technology and analytics provider that delivers an unprecedented view into risk adjustment so health plans can achieve the highest financial impact in the Commercial Health Exchanges and Medicare Advantage markets. Its proprietary algorithms move beyond traditional methods and data sources to make predictions about what individual members require next, ultimately closing gaps in care and increasing precision with risk adjustment initiatives. Pulse8 offers innovative and unique methodologies in its Health Exchange Suite™ to ensure its clients outperform the marketplace. Its transparent and flexible business intelligence tools give real-time visibility into member and provider behaviors allowing clients to apply the most cost-effective and appropriate interventions. For more company information, please contact Pulse8 at (410) 928.4218 or visit http://www.Pulse8.com and follow Pulse8 on Twitter at https://twitter.com/Pulse8News

Medivo is a healthcare data analytics company that unlocks the power of lab data to improve health. Medivo is the largest source of lab data in the U.S., with access to over 150M patients through its nationwide network of partner labs. Medivo analyzes large data sets and shares its findings with the medical community at large, as well as with its payer, lab and life science partners, to ensure that appropriate available treatments are provided to patients sooner.

Medivo’s Lab Data Advantage™ applies clinical analytics to lab data to provide payers with material health plan value by supporting Care Management Programs, HEDIS/STAR and Risk Adjustment initiatives by identifying gaps in quality and care, disease status changes and improvement in outcomes.

Labs in the U.S. are highly fragmented, and depending on the lab, patient records are often incomplete and contain unstructured data, rendering the data unusable for certain use cases. Medivo provides a “one to many” connection from payers to labs that intakes, refines, standardizes, and enriches the data to ensure actionable data output. Founded in 2010, Medivo’s investors include Safeguard Scientifics, Inc. (NYSE:SFE) and Merck Global Health Innovation Fund (GHIF). Learn more about us at medivo.com, reach out to Bob Maluso with questions, and follow us @gomedivo or on LinkedIn.

Health Fidelity’s risk adjustment solution is the most comprehensive, scalable solution in the market for perfecting the risk adjustment cycle. Our cutting-edge technology combines big data analytics and natural language processing (NLP) to automatically extract valuable insights from medical charts to enhance prospective and retrospective RAF processes. Equipped with this proprietary technology and a team of industry experts, Health Fidelity can help organizations optimize their coding operations to increase efficiency, achieve better compliance, and maximize value through improved identification of HCCs.

 

Talix provides patient risk management solutions to help healthcare organizations address the challenges of value-based healthcare and risk-based contracts. Its SaaS applications leverage patient data analytics to turn structured and unstructured health data into actionable insights that drive improved risk adjustment, better patient outcomes and reduced costs.

Episource provides US health plans and other risk adjusting organizations with powerful data analytics, tools, and insights to drive interventions, benefiting patients and providers alike.? Solutions offered include risk adjustment and quality data analytics, medical coding, encounter data submission, and medical chart retrieval.

As a healthcare business services and technology company, Episource is constantly striving to help its clients simplify the complex challenges of the healthcare industry with specialized services, and innovative technology. Headquartered in Los Angeles, the Company has over 1,500 professionals with extensive experience in risk adjustment.

DST Health Solutions, LLC delivers contemporary healthcare technology and service solutions that enable its clients to thrive in a complex, rapidly evolving healthcare market. Supporting commercial, individual, and government-sponsored health plans, health insurance marketplaces, and healthcare providers, DST Health Solutions’ services include enterprise payer platforms, population health management analytics, care management, and business process outsourcing solutions, each designed to assist a company manage the processes, information, and products that directly impact quality outcomes. DST Health Solutions is a wholly-owned subsidiary of DST Systems, Inc. For more information visit www.dsthealthsolutions.com.

Matrix Medical Network is the leader in supporting care in the home through our national network of Nurse Practitioners. From in home assessments to chronic care support, Matrix helps health plans engage members and their physicians to ensure members receive needed care, improving their health and overall outcomes.

Gold Sponsors

Advance Health is dedicated to assisting health insurance companies navigate the challenges of the current and future environment by helping members lead healthy and productive lives.

Advance Health offers prospective health risk assessment, readmission prevention and care management services.  Our providers capture data about members using our proprietary iPad application.  Electronic capture means data needed for a prospective campaign, HEDIS capture or care management initiatives are available almost instantly in a searchable database.  We partner with our clients to offer real-time reporting and transparency into our operations.

Dynamic Healthcare Systems, Inc. delivers comprehensive solutions for Medicare Advantage health plans striving to succeed amid new and evolving regulatory requirements.  Our Medicare solutions address the following business areas of a health plan operations: Enrollment processing, Plan Reconciliation, Risk Adjustment Analytics and Data Submission, Encounter Data Processing Prescription Drug Event Data Management and Audit and Member Premium Billing Processing.  We deliver our solutions either as integrated software and services or standalone software solutions to the strongest plans in the market.

 

Edifecs is a leader in developing innovative, cost-cutting solutions to transform the global healthcare marketplace. Since 1996, Edifecs has provided technology that automates many administrative functions in order to trim waste and reduce costs as well as increase revenues, collaboration and operational performance. Customers who have benefited include healthcare providers, insurers, pharmacy benefit management companies, and other trading partners. More than 250 healthcare customers today use Edifecs solutions to simplify and unify financial, clinical and administrative transactions. They also use Edifecs technology to automate manual business processes (e.g., enrollment, claims and payments management) and to support compliance for HIPAA, Operating Rules and ICD- 10 mandates. In addition, Edifecs develops supply chain management solutions to support worldwide customers in non-healthcare industry segments. Edifecs is based in Bellevue, WA, with operations internationally. Learn more about us at edifecs.com.

Peak focuses on delivering Risk Adjustment and Quality Solutions to provide our clients with full service and customized options that give you the ability to choose services which best meet your needs. Peak provides top quality staff, a state-of-the-art technology workflow, chart reviews, in-home assessments and chart retrieval specific to your needs. With Peak as your partner, you will receive quality, timely results from a caring team of professionals that will guide you through the challenges of this ever changing industry.

 

Advantmed is a health information management company that helps risk-bearing entities optimize revenue and improve quality outcomes.  We accomplish this fundamental objective by using our proprietary Elevate! Healthcare™ health information management platform to deliver and manage integrated products and services, which help clients capture, organize, and analyze financial and clinical data to better understand their member populations and ultimately utilize this data to improve quality of care and optimize risk-adjusted revenue.  Through the platform, Advantmed partners with managed care organizations to deliver the optimal combination of capabilities unique to each organization’s objectives, including risk analytics (ELEVATE! Risk Insights™), NCQA-certified HEDIS® Measures software (ELEVATE! Quality Insights™), medical record retrieval, medical record abstraction, risk adjustment coding, compliance and data validation services, member engagement, provider education, and professional services.

 

Apixio is the leading provider of Big Data analytic solutions for risk-bearing healthcare organizations seeking to optimize costs and outcomes.  Apixio transforms coded, textual and scanned data into real-time insights that enhance risk assessment, population management and reimbursement.  Apixio’s solutions seamlessly integrate into clinical and administrative workflows, allowing clients to reap immediate benefits and achieve continued success in a rapidly changing healthcare environment.

Mile High Healthcare Analytics provides practical population-oriented analytics to health plans, Exchange issuers, ACOs, and risk-bearing provider groups.  Our strategic consulting focus is on risk adjustment operations, performance measurement and improvement, Stars, the Quality Rating System, and alternative payment designs.  We provide business process assessments, operational assessments, and feasibility studies-- striving to improve the operational performance of our clients.

Mile High Healthcare Analytics is also data-focused.  We analyze large and complex datasets of patient-level data from claims, pharmacy, clinical laboratory results, member enrollment, and supplemental data. Our healthcare analytics pay as much attention to the underlying completeness of the data as to the analytic models.  With good data we derive and validate predictive models in clinical, operational and financial areas for healthcare organizations bearing financial or insurance risk.  Mile High ensures the validity of the results from analytics and the applicability of those results to our clients’ objectives.

Altegra Health™ is a national vendor of technology-enabled, end-to-end payment solutions providing health plans and other risk-bearing organizations with the data they need to expertly manage member care and ensure appropriate reimbursement.

The power of Altegra Health’s advanced analytics and supporting interventions enables healthcare organizations to elevate care quality, optimize financial performance, and enhance the member experience. For more information, visit AltegraHealth.com

Silver Sponsors

At Truven Health Analytics, we are dedicated to delivering the answers our clients need to improve healthcare quality and reduce costs. We are a healthcare analytics company with robust, widely respected data assets and advanced analytic expertise that have served the global healthcare industry for more than 30 years. These combine with our unique perspective from across the entire healthcare industry to give hospitals, clinicians, employers, health plans, government agencies, life sciences researchers, and policymakers the confidence they need to make the right decisions, right now, every time. With our healthcare-specific expertise and tools for managing complex and disparate data, we understand how to implement and integrate tailored analytics that drive improvement.

Truven Health Analytics owns some of the most trusted brands in healthcare, such as Micromedex, ActionOI, 100 Top Hospitals, MarketScan, and Advantage Suite. Truven Health has its principal offices in Ann Arbor, Mich.; Chicago; and Denver. For more information, please visit truvenhealth.com.

ArroHealth, formerly MedSave USA, is a full-service provider of risk adjustment and HEDIS services offering a suite of analytics, medical record retrieval and coding, and in-home and in-office assessment products.  These services are offered on a unique and proprietary technology platform designed for excellence in results, quality, and transparency. ArroHealth recognizes the importance of performance and accuracy and provides the most extensive performance guarantees in the industry.  We focus on chart collection rates, timing, ROI, provider satisfaction, accuracy, and quality.  In addition, we provide full transparency into all that we do for clients; allowing them to adapt quickly and maximize financial and clinical results.  This includes unfiltered access to back-end systems, enabling clients to see ― in real- time ― the smallest details of their projects’ status. ArroHealth serves most of the top national health plans as well as many regional and local plans and is committed to accuracy, intelligence, and impact for clients.

Headquartered in Ann Arbor, Michigan, ATTAC Consulting Group (ACG) specializes in compliance solutions, auditing, business operations and process controls, for insurers and healthcare organizations.  ACG focuses on the space between what’s supposed to happen on paper and what’s actually happening on the ground.  Our firm assists our clients identify and resolve the difference.

ACG’s  team  of  professionals  is comprised  of industry experts with  extensive real-world,  hands-on  experience   working in,  and with,  the organizations operating government health programs including:  Medicare Advantage, PDP, Medicaid and Duals, Qualified Health  Plans  (QHPs), ACOs  and provider groups.   Our team focuses on   institutionalizing compliance throughout health plan operations to enhance efficiency and return on investment.

ACG’s audit specialties include:

CMS Performance Audits, Data Validation Auditing, Third-Party Corrective Action Outcome Validation, CMS Financial Audit Preparation, First Tier, Downstream and Related Entity Monitoring and Auditing, QHP Compliance Auditing, Development of Internal Monitoring, Auditing and Process Controls

EMSI Health empowers health plans with end-to-end risk-adjustment services for care management, quality support and improved risk score accuracy.  We offer best-in-class risk analytics,  in-home assessments, medical chart retrieval, coding, risk profiles, audit support, and Stars and HEDIS measurement support to health plans in all markets.  StratusIQ, our web-enabled customer portal and data repository, provides clients with easy and transparent access to their project data and our self-scheduling tool allows members to efficiently and conveniently schedule Healthy House Calls® anywhere, anytime.  Our integrated approach leverages experienced industry professionals, proven and secure technology, and flexibility to produce the best quality results for health plans and improved outcomes for plan members. EMSI Health: Powerful Information. Improved Outcomes. Learn more at http://www.emsinet.com/EMSI-Health.

 

 

Centauri Health Solutions improves member outcomes and financial performance for health plans and at-risk providers by supporting initiatives in Risk Adjustment, RADV Risk Mitigation, HEDIS, Star Ratings, and Care Gap Management.

Our consultative approach delivers compliant end-to-end solutions that leverage clinically-rich data analytics, workflow software tools, and other technology and service resources. We identify risk adjustment gaps, care and quality gaps, and support the closure of those gaps to benefit our clients and their members.

We know from experience that data alone is not enough – the combination of data, experience, and execution is required to improve outcomes in today's environment.

Centauri's core leadership team is comprised of seasoned healthcare executives from managed care organizations, pharmacy benefit managers and HCIT companies. They understand from personal experience the challenges facing today's health system – and have set out to resolve them in a better way for their clients and their members / patients. 

Centauri partners with respected Medicare Advantage, Managed Medicaid and Health Insurance Exchange plans, as well as at-risk provider groups to answer critical business questions such as whether they are impacting the members who are the most at-risk, how much financial exposure they may face due to RADV audit and compliance risk, and whether they are optimally utilizing their scarcest resources.

Welltok, Inc., developer of the healthcare industry's first consumer enterprise platform, is transforming the way population health managers guide and incentivize consumers to optimize their health. The CaféWell Health Optimization Platform® organizes the growing spectrum of health improvement and condition management resources, obtains unparalleled consumer insights through advanced analytics, and leverages multi-channel communications to connect consumers to the right resources, at the right time.

Bronze Sponsors

CenseoHealth is a leading provider of prospective health risk assessments for health plans and healthcare delivery organizations. Our physicians perform comprehensive, Annual Wellness Visit-compliant evaluations with members in their home, at network physician offices and in community settings. We capture a complete health and lifestyle assessment to drive better clinical outcomes through care management referrals and return-to-care recommendations. Our insights help enhance member engagement, improve quality ratings and reduce overall healthcare costs. Our network of nearly 5,000 licensed physicians are uniquely qualified to identify and diagnose health conditions. We have completed more than one million assessments, averaging more than 1,800 per day.

Gorman Health Group, LLC (GHG) is a leading consulting and software solutions firm specializing in government health programs, including Medicare managed care, Medicaid and Health Insurance Exchange opportunities. For nearly 20 years, our unparalleled teams of subject-matter experts, former health plan executives and seasoned healthcare regulators have provided strategic, operational, financial, and clinical services to the industry, across a full spectrum of business needs. Further, our software solutions have continued to place efficient and compliant operations within our client’s reach. Find out more at www.gormanhealthgroup.com.

MediCheck™ is a proactive health risk assessment program offered by ExamOne that gets to the source of actionable data. Our program can help maximize your resources, close gaps in care, improve quality outcomes and attain bonus payments. With an industry-leading health outreach team, MediCheck helps improve discovery, identification and documentation of member medical conditions through mobile laboratory and biometrics collections, as well as comprehensive in-home health assessments, ultimately helping you stay on target with quality reporting deadlines. Learn more at MediCheck.ExamOne.com.

Thank you to all of our RISE Sponsors!

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Upcoming Conference

 

The 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

360° Risk Adjustment: A Strategy for Success in the Value-Based Care Era

 

In this webinar, attendees will discover that when risk adjustment is treated as a priority – not just as an actuarial exercise – and brought into the organization’s long-term strategy, it can be properly leveraged as an asset to drive growth and advance the organization’s mission of keeping patients healthy. Risk-bearing entities who embrace a 360° approach to risk adjustment will outpace their competitors in the transition to value-based care models.

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