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What’s New in Risk Adjustment? Regulatory Updates and Process Evaluation

Dates:
May 9, 2023
Time:
12:00 pm EDT
Presented by Inovalon lateral 2020
Register Now Registration takes place at a third-party website.

About This Webinar

Obstacles remain that can limit a health insurance provider’s ability to run an accurate, effective, risk score accuracy program. Evolving risk adjustment models and regulations have made it even more important for health plans to resolve challenges like lack of transparency into member data and risk scores, inefficient and disjointed processes, inadequate expertise, or program customization capabilities:

  • Lack of transparency into risk scores
  • Inefficient and disjointed processes
  • Missing risk score goals/forecast

In this webinar, industry experts will discuss best practices for managing health plan risk adjustment processes amid the Centers for Medicare & Medicaid Services (CMS) RADV Final Rule and 2024 Final Call Letter for Medicare Advantage plans. Attendees will learn how converging health plan quality, risk, and other healthcare programs can ensure greater data accuracy, drive major improvements in efficiency, and support better member satisfaction and experience.

You'll also learn about the impact of recent Federal regulatory changes, hear observations about the MA and ACA programs, and gain best practices for managing risk adjustment processes more efficiently and effectively.

Attendees Will Learn About

  • The impact of CMS regulatory changes
  • Best practices for managing your risk adjustment processes
  • Combining quality and risk
  • Finding a resource that is prepared for the regulatory changes and that fits your business needs

Presenters

Lalith Mehta, MBA

Vice President, Product & Analytics

Inovalon

Mr. Mehta is a seasoned executive with extensive experience in the healthcare and technology domains. Currently serving as the VP of Risk Adjustment Product and Analytics at Inovalon, he is responsible for overseeing the product management, and analytics of risk adjustment solutions for Medicare, Medicaid, and Commercial Risk Adjustment products. With more than 14 years of experience at…

Learn more about Lalith Mehta, MBA

Kathleen (Kate) Marta

VP, Clinical Quality, Training, Oversight and Innovation

Inovalon

Ms. Marta has been with Inovalon since 2008 and serves as the VP, Clinical Quality, Training, Oversight and Innovation. In this role, she is responsible for coding and abstraction oversight for all clinical review staff, and also oversees the Quality Clinical Review Team, which is responsible for performing client audits and monitoring quality oversight. Ms. Marta began her career in the early…

Learn more about Kathleen (Kate) Marta