RISE’s virtual training series will return with three comprehensive seminars on the fundamentals of Medicare Advantage and Medicaid: quality, risk adjustment, and social determinants of health (SDoH). Here’s everything you need to know about each seminar.
Whether you’re an experienced health care professional or new to the industry, The RISE Bedrock of Health Care training series is a comprehensive resource with agendas curated based on feedback from a team of RISE fellows─ industry experts who were appointed to ensure the programs are timely and informative. The live-streamed courses will include hands-on exercises and real-time Q&A.
Here’s a closer look at the three sessions:
The SDoH seminar, held March 25-26, from 12pm- 4pm EST, will be a community-based organization (CBO) boot camp, with a focus on key strategies to partner with health care to address SDoH in your community. While the session is tailored for CBOs, it will offer valuable information across health care sectors, fostering cross-sector collaboration and equipping attendees with strategies to secure funding, scale programs, and maximize reimbursement opportunities, to deliver meaningful support to vulnerable populations.
Agenda topics include:
- Speaking the same language
- The building blocks for a scalable SDoH program
- Capturing and utilizing meaningful data
- Navigating managed care plans
- Identifying sustainable partnerships
- Policy landscape for 2025 and beyond
- Uncovering funding sources
- Reimbursement essentials for optimizing funding
The risk adjustment seminar, a spotlight on core concepts of risk adjustment models, will take place April 29-30 from 12pm – 4pm EST. The session will explore core concepts of risk adjustment models in Medicare Advantage, Affordable Care Act (ACA), and Medicaid, as well as the managed care landscape with a focus on Centers for Medicare & Medicaid Services (CMS) payments, learning key components of risk adjustment, and the nuts and bolts of compliant revenue management within a health plan or a risk-bearing provider organization.
Agenda sessions include:
- An introduction to risk adjustment
- Understanding risk scores
- Unpacking the fundamentals of the V28 model
- Transitioning to the V28 model
- Strategies to partner with vendors
- The provider’s role in risk adjustment
- Demystifying audits
- RADV audit preparation for success
The quality seminar will be a best-in-class comprehensive education on quality programs for health plan professionals with a range of experience levels. It will be held this summer on June 17-18 from 12pm-4pm EST. The training will focus on the information quality professionals need to know to help meet their plan’s goals for quality of care and member satisfaction.
Agenda topics include:
- CMS, Medicare, and quality
- Medicare Star ratings
- The essentials of Stars math
- CAHPS and the measurement of member experience
- The fundamentals of HEDIS®
- HEDIS® ECDS measures and the move to digital quality measurement
- Additional quality programs
- The intersection of quality and health equity
Editor’s note: HEDIS® is a registered trademark of National Committee for Quality Assurance (NCQA) and any reference thereto by RISE Health does not imply any endorsement by NCQA of RISE Health and its offerings.
Click here for more information on The RISE Bedrock of Health Care virtual training series, including registration information, speakers, and more.