Update on RISE RAPS / EDS Industry Collaboration with Inovalon

Closing Off Contracting Shortly!

The industry collaboration that RISE has pioneered with several healthplans is making significant progress with business partner, Inovalon, under Jason Rose's leadership.  There are several MAOs now confirmed for participation in the joint study project, some in final contracting stages, putting the aggregated MA membership at roughly 500,000 and climbing.  

Given the CMS announcement that they plan to publish the final MAO-004 filtration guidance in December, we have taken a few more weeks to recruit as many healthplans into the project as possible.  The project support provided by Inovalon has enabled us to continue discussions with plans that expressed interest and bring them onto the project.  We will be wrapping up recruitment by approximiately October 31 so we can begin crunching the numbers for the plans that committed to signing up, allowing us to complete the first round of the study by the end of December.  Representations of participating MAOs may want to join our Steering Committee. 

Our Steering Committee now includes:  

  • Dave Meyer, SCAN Health Plan (RISE Board Member)
  • Kathy Graf, Emblem Health
  • Brian Bodnar, Horizon BC in New Jersey
  • Larry Bishoff (RISE Board Member)
  • Jason Rose, Inovalon (RISE Sponsor Advisory Board Member) 
  • Tom Kornfield, Avalere

Our Collaboration Steering Committee is also announcing the addition of Tom Kornfield, former CMS executive.  As explained in the announcement by Avalere, recently acquired by Inovalon, "Tom served as a senior advisor in the Center for Medicare and Medicaid Innovation (CMMI) where he assisted in developing alternative payment models in Medicare Advantage.  Prior to joining CMMI, he was the director of the Division of Payment Systems in the Medicare Plan Payment Group (MPPG) at CMS where he led the 2014 and 2015 Medicare Advantage and Prescription Drug Plan payment rate announcements, and served as the technical lead on risk adjustment. "  http://avalere.com/news/former-cms-officialtom-kornfield-joins-avalere  We are very pleased to welcome Tom to our group and we look forward to incorporating his insights and perspective into the guidance and thought process behind our joint study. 

Categories: risk adjustment, RAPS, EDS
Tags: RISE, industry collaboration

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