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 providing cloud-based platforms empowering a data-driven transformation from volume-based to value-based models throughout the healthcare industry. Leveraging large-scale data interconnectivity capabilities, unparalleled proprietary data sets, advanced analytics, data-driven intervention systems, and industry-leading subject matter expertise, Inovalon enables the assessment and improvement of clinical and quality outcomes and financial performance across the healthcare ecosystem. From health plans and provider organizations, to pharmaceutical, medical device, and diagnostics companies, Inovalon's unique achievement of value is delivered through the effective progression of “Turning Data into Insight, and Insight into Action®.” Providing technology that supports nearly 500 healthcare organizations, Inovalon's platforms are informed by data pertaining to more than 858,000 physicians, 377,000 clinical facilities, and 230 million Americans, and nearly 30 billion medical events.

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

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.

 

 

 

Integra ServiceConnect engages members through deeply personalized face-to-face interaction, driving increased participation in risk adjustment, case management, and other clinical and quality outcome initiatives. Our team of highly-trained outreach specialists are consistently successful in reaching up to 50% of members that cannot or have not been engaged through standard outreach campaigns.

Integra’s services can be used for short-term, targeted initiatives or high-touch, long-term programs, and can be customized to meet a plan’s specific needs for members in any market and line of business. We seamlessly integrate into the programs and vendor relationships that are already in place, and can be running within 90 days. Our services have been used to engage members for in-home assessments and health risk assessments, connect members to case management, close members’ care gaps, and coordinate better care for members by addressing the social determinants of health.

In-person engagement of high-risk, high-need members delivers superior results. Developed over time, Integra’s disciplined approach includes hiring the right staff and equipping them with the training and tools necessary to achieve high levels of member engagement and satisfaction. Our confidence in our unique people-finding methodology is high, so we are success-fee only.

In the field, Integra acts as an ambassador, demonstrating the plan’s commitment to educating and connecting members with appropriate services. Moving beyond call center campaigns, our solutions ensure appropriate risk adjustment revenue while improving medical management and quality measures for the plan. 

Prognos is a healthcare AI company focused on eradicating disease by driving decisions earlier in healthcare in collaboration with payers, Life Sciences and diagnostics companies. The Prognos Registry is the largest source of clinical diagnostics information in over 30 disease areas, with over 5B medical records for 100M patients. Prognos has 500 extensive proprietary and learning clinical algorithms to enable earlier patient identification for enhanced treatment decision-making, risk management and quality improvement. The company is supported by a $23M investment from Safeguard Scientifics, Inc. (NYSE:SFE) and Merck Global Health Innovation Fund (GHIF). For more information, visit www.prognos.ai.

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.

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.

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

Discovery Health Partners offers payment and revenue integrity solutions that help health payers improve revenue, avoid costs, and enhance the member experience. We offer a unique combination of deep healthcare expertise and analytics-powered    technology solutions to help our clients improve operational efficiency, achieve financial integrity, and generate measurable results. 

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 1.5 million assessments, averaging more than 1,800 per day.

Silver Sponsors

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

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

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 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

Quality Visits: Closing Gaps in Care to Meet Your Quality Performance Goals

Meeting and exceeding quality standards has never been more important for health plans as reimbursement is increasingly linked to specific quality goals. This informative webinar will help you understand how to gain control over meeting your quality goals by executing targeted interventions for those members with gaps in care. You’ll get a glimpse of how to coordinate everything from member outreach and engagement, to actual gap closure and reporting to the member, their primary care provider and the health plan.

 

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