RISE Institute

The RISE Associations introduces the RISE Institute, a training, and education program developed for health plan industry professionals on targeted subjects. The RISE Institute currently offers two intensive, collaborative risk adjustment workshops for CMS & HHS risk adjustment. With content that dives into the role of risk adjustment, HCC coding, and management tools needed, these workshops are your comprehensive education into Medicare risk adjustment. Each workshop is offered throughout the country, to allow you to choose the date and location that is most convenient to your schedule. (Formerly known as the RISE Academy.)


Workshops

CMS & HHS Risk Adjustment 101 & HCC Coding Accuracy: Gives You a Comprehensive Perspective

CMS and HHS Risk Adjustment & HCC Coding 101 day one contains a lot of content for the newbies to risk adjustment or as a refresher for the pros.  On day one, your understanding of the how / what / where and why of “risk adjustment” will dramatically improve. Our curriculum covers all the bases, whether you are working on Medicare Advantage or on commercial health insurance exchange lines of business. We welcome the newcomers to risk adjustment as well as experienced professionals needing a holistic orientation to the risk adjustment panorama--you can’t get this anywhere else!

And, day two focused deeper on HCC Coding for Accuracy.  For those involved in HCC coding work, there is nothing like this highly interactive event anywhere else. Hear directly from experts and work through case examples. Join your peers sharing their experiences, and bring your own questions to put on the table for the group. This is HCC coding with the financial dimensions layered in. We tell you how it differs from FFS coding when payment is based on E&M codes. 

No prerequisite required.

Click here for more info.

 

Leading and Implementing HCC Program: Full of Managment Tools

This two-and-a-half-day workshop lays out best practices for an end-to-end method of aligning chart documentation, HCC code capture and audit readiness at both the provider and health plan levels. There is finally an industry standard through the RISE Risk Adjustment Academy! Whether you are working on Medicare Advantage, Medicare ACOs or on commercial health insurance exchanges, this approach works across all lines of business. For providers involved in ACO programs, this workshop puts you in the driver’s seat, when many ACOs are just learning how coding and documentation affects their risk sharing opportunities. Our faculty has been around the block a few times and can share the insights they have garnered in their careers: learn from the best!

Our mantra in this program is: “one process from the point of care onwards”.  That means no matter what line of business you are working in, and no matter whether you are auditing or doing quality, everything boils down to getting it right in the exam room the first time.  From there, the whole process needs to be high quality to get everything else right downstream. There does not need to be different processes for different lines of business or for different payers:  make it simple and make it consistent!

No prerequisite required.

Click here for more info.

 


Workshop vs. Conference - Which do I choose?

In short, it depends on what you are looking for.  If you already have the foundation knowledge of risk adjustment and coding, the conference will keep you current on issues.  On the other hand, if you are not yet fully prepared for risk adjustment and coding, you would not get as much out of the conference without the preparation provided by the workshop. 

Workshop Benefits

  • Free standing workshop with standardized material to provide a consistent, through education on risk adjustment and HCC Coding
  • Intended to be a comprehensive course for, primarily to ensure that pros in the field know and are familiar with the whole scope, filling in gaps in knowledge or as an intro for new professionals
  • Small faculty to teach, train, and prepare people for their role in risk adjustment
  • 25-30 people seated in round tables for collegiality, networking, and a more intimate learning atmosphere

RISE Conference Benefits

  • Structured to offer multiple speakers on multiple topics of interest each from their own perspective
  • Wider range of topics other than risk adjustment
  • Not designed to be comprehensive, but is timely subjects and topics
  • Attracts a much larger audience with a more diverse background of job titles and roles
  • Vendors with their exhibits to learn about new technologies and shop for services, if you desire 

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Upcoming Conference

 

The Risk Adjustment Forum: Operational Integration and Compliance 

This is your can't-miss opportunity to gain proven strategies for enhancing the compliance of your coding and risk adjustment data. You also will get unparalleled insight and tools to help streamline the integration of risk adjustment and quality initiatives, and take away critical lessons learned from plans breaking down operational silos. You will also hear directly from CMS! 

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Upcoming Webinar

Walking the Line: Balancing Claims, Premiums, and Compliance for Medicare Advantage Plans

Medicare Advantage plans walk a tight line when paying claims, managing premiums, and monitoring compliance demands. On one hand, they must ensure they receive the right premiums from CMS and pay claims correctly to cover the cost of care for their membership. On the other hand, CMS needs to ensure plans spend premiums responsibly in accordance with regulations. Medicare Advantage Plans must carefully consider the intertwining dependencies within their plans and with CMS, which can impact their ability to maximize the bottom line while managing compliance.

 

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