Risk adjustment
remains the defining issue for Medicare Advantage health plans and is
central to improving the quality of care provided to chronically-ill
beneficiaries. Many health plans have already come to realize that
prospective health risk assessments are the most effective way to bring
risk adjustment and case management together to drive better revenue,
better medical management, better Star Ratings and higher patient
satisfaction. For some though, the majority of diagnostic information is still collected from claims-based submissions often augmented by retrospective review of selected charts. Recent audit experience has repeatedly shown that this information to be incomplete and often incorrect—at great risk to the plan. In fact, studies done on risk adjustment implementation suggest that as many as 17% of claims-based submissions could not be supported by charts. RADV audits have documented variances closer to double that number. In partnership with MCOL, join Gorman Health Group and CenseoHealth for a discussion on a new model for mastering the risk adjustment payment of Medicare Advantage plans on February 22 from 1:00-2:00 Eastern time. Hear from Dr. Jack McCallum, CEO of CenseoHealth, on how a well-designed prospective risk adjustment program can help to ensure plan compliance. He’ll be joined by Nathan Goldstein, CEO of Gorman Health Group, for a discussion on practical program steps and enhanced techniques designed not only to drive risk-adjusted revenue, but also quality Star Ratings and enhanced medical management. |
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Participants will be able to:
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Interested attendees would
include:
Attendees would represent organizations including:
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