Medicare Advantage Case Study: Success in
Risk Adjustment

  • December 03, 2020
  • 2:00 PM – 3:00 PM ET
  • Online
about

Currently, 36% of Medicare beneficiaries are enrolled in Medicare Advantage (MA), and the enrollment rate is set to reach 42% over the next 10 years. As health insurance providers prepare to support a growing membership or enter the MA market, a strong risk adjustment strategy is critical for success. Pandemic-driven issues have also required a shift in managing risk adjustment programs. Risk analytics can play a key role to support strategy, inform action, and deliver results.

Risk adjustment analytics are the cornerstone to most health plan’s risk revenue results. During this webinar, one health insurance provider will share how they re-entered the Medicare Advantage market, leveraged analytics to inform strategy, and continue to achieve better results through actionable business intelligence.

Attendees will learn how to:

  • Leverage risk analytics for targeting both prospective engagement opportunities and retrospective chart chases
  • Engage providers for more accurate and complete coding
  • Improve submissions processes to achieve better CMS acceptance rates
  • Enhance chart retrieval and coding programs through advanced analytic insights

Speakers


Eric Doremus
Manager, Risk Adjustment Programs Analytics
Medical Mutual of Ohio

In his role, Eric leads the effort to create data-driven solutions that help support the Medicare Advantage and Affordable Care Act businesses at Medical Mutual, which rely heavily on government risk adjustment revenue to maintain profitability. He helps detect data trends and patterns that will help form the strategy of future risk adjustment programs and identify key metrics and measurements that indicate program success.


Jeff Savilla
Program Manager, Risk Adjustment
Change Healthcare

In his role, Jeff delivers daily client support, coordinating and leading all aspects of multiple, concurrent projects from inception through completion. He collaborates with health plan clients to clarify complexities and create clearly aligned goals to help ensure all objectives are met in every project and implementation.

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