As CMS becomes even more engaged in its oversight of Medicare Advantage risk-adjustment programs, MA plans face significantly greater financial and compliance risk for their failure to implement critical risk-adjustment program elements, including adequate vendor oversight and internal audit systems. The continued decline of payment rates means the ability of MA plans and capitated medical groups to ensure accurate risk scores is not only critical to strategic forecasting and planning, it’s becoming a fundamental survival issue. MA plans are preparing for the 2014 program year and its complex risk-adjustment model, and now is the time to get your arms around the multiple vendors, variable procedures and lack of oversight in risk-adjustment programs.
The On-Demand recording will be available immediately upon purchase* as a link within a PDF file of the accompanying written materials. CDs and printed materials are shipped via USPS.
Most MA plans use multiple vendors to execute elements of their risk-adjustment programs, and these important functions are often performed without effective oversight and audit systems. CMS ultimately holds the MA plan responsible for incorrect coding — and up to 30% of codes coming from claims are not found in the chart when audited. Even the most advanced MA plans struggle with slow vendors, ill-defined internal processes and a lack of confidence in the process and accuracy of codes being submitted.
Hear experts from Gorman Health Group, LLC outline the components of a successful risk-adjustment program. You’ll get reliable guidance and strategic information on topics such as:
Gorman Health Group’s the Point is teaming up with Atlantic Information Services, Inc. on an exclusive series of webinar presentations designed to provide the timely and meaningful information the Government health care industry needs to implement health reform. From expert analysis on the latest regulatory updates to war stories and best practices from our seasoned consultants, these webinar presentations deliver what you need to transform regulatory policy into operational reality. Members of GHG’s the Point attend the live webinar presentations at a discounted rate. Claim your discount now. Not a member yet? Learn about all the benefits of joining the Point.
RAEANN GROSSMAN is the Chief Sales and Marketing Officer at Gorman Health Group, LLC. She is one of the nation’s foremost experts on Medicare and Medicaid operations, population health management especially focusing on chronic and complex members, risk adjustment, provider and payer alliance configurations, and member engagement. RaeAnn rejoins GHG from CenseoHealth, where she was senior vice president. She previously worked at OptumInsight as vice president of Medicare and Medicaid solutions. In the past six years, RaeAnn was one of the founders and principal investors in the first full-service risk adjustment management company for Medicare Advantage where she held the position of chief client services officer. Prior to that, RaeAnn worked as Health Net of Arizona’s vice president of network strategy and development, Scottsdale PHO, and BCBSAZ.
Moderator: Jill Brown, executive editor of AIS
CDs (and accompanying written materials) are shipped via UPS. Please give us your street address when you order (UPS does not deliver to PO boxes). You should receive your order within two weeks.* Shipping and handling cost is $12.
The On-Demand Recording will be delivered as a link within a PDF file of the accompanying written materials. Shipping will NOT be charged for this item.
Rush Orders: Please call us at 800-521-4323 to place a rush order.* We will overnight your order for an additional charge of $30, or you can give us your FedEx or UPS account number and we will charge the shipping to your account. Rush orders placed after 3:00pm EST will not be shipped out until the next business day.
*On-Demand recordings will be available within a week of the conference and CDs will be available within two weeks.
Listeners will also receive practical written information to supplement information covered by the Webinar speakers. A copyright release in the Printed Materials will permit you to make photocopies for each person listening to the Webinar and/or the On-Demand Recording.
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