360° Risk Adjustment: A Strategy for Coding Optimization

  • March 02, 2017
  • 2:00 PM – 3:00 PM ET
about

Pressures on risk adjustment – including risk-based model enrollment growth, increasingly complex data submission requirements, scrutiny from regulators, and downward reimbursement pressures – are signaling the waning utility of traditional approaches.

In the era of value-based care, an integrated, comprehensive framework is required to address the ongoing financial, patient care, and competitive challenges facing risk-bearing organizations.

Traditional risk adjustment approaches have been perceived as simply “checking the boxes” – performing a set of tasks that comprise a required actuarial exercise – instead of a crucial effort that has far-reaching implications across the organization.

In this webinar, attendees will discover that when risk adjustment is treated as a priority 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.

Webinar participants will:

  • Discover a fundamentally new way to perform risk adjustment that considers optimization from all angles, including how to:
    • modernize technology
    • enhance provider collaboration
    • integrate across multiple departments
    • transform risk adjustment into a strategic lever
    • obtain performance control and transparency
    • evaluate risk adjustment vendors and partners
  • Learn about the 8 components of the 360° Risk Adjustment framework and leave with recommendations for driving success in each area
  • Uncover how to assess the status quo and develop a performance baseline for measuring success
  • Gather evidence to build your business case for investing in risk adjustment improvements
  • Create a blueprint for improvement by adopting our transformation planning framework

Who should attend: Managers, Directors, and Executives responsible for Risk Adjustment, Quality, Value-based Care Strategy, Finance, and Government Programs.


Speakers:


anand-shroffAnand Shroff, Founder, Chief Development Officer, Health Fidelity
Anand is one of the founders of Health Fidelity and is responsible
for leading corporate strategy, business development, sales, and
marketing. His industry experience coupled with his background
as Founder brings incredible value to our commercial efforts as
Health Fidelity continues to develop and grow.

At Health Fidelity, Anand helped found the company, guided the development of its technology and fostered key relationships with UPMC and Columbia University. Prior to founding Health Fidelity, Anand was Vice President of EHR and HIE products at Optum. He came to Optum by way of acquisition of Axolotl Corporation, a visionary company in the HIE movement, where he was Vice President of products. Anand was a founding member of the Oracle Health Sciences business unit and headed the product organization that was responsible for creating the earliest commercial healthcare analytics products in the industry.

Anand has an MBA from the Haas School of Business at the University of California, Berkeley in addition to an MS in Computer Science from the University of California, Santa Barbara. Anand has an undergraduate degree in Computer Engineering from the University of Mumbai.

 

Teresa RossTeresa Ross, Solutions Architect, Advisory Services, Health Fidelity
Teresa joined Health Fidelity in 2016 with over 30 years of healthcare industry experience. Over the last 18 years, Teresa has been a leader in the risk adjustment space, holding Director-level roles for a variety of payer organizations, including a mixed-model HMO and a health plan.

From 2013 to 2016, Teresa was Director of Medicare Product Analytics and Revenue Management at Regence BlueCross BlueShield in Oregon, where she markedly increased the maturity of their risk adjustment program. During her last year at Regence, she developed a provider engagement program which included an incentive plan and mechanized reporting of care gaps to primary care providers.

Previously, Teresa spent nearly 15 years at Group Health Cooperative, where she led profit line and employer group reporting. Teresa has an undergraduate degree from Knapp College of Business.