Name: What’s New in Risk Adjustment? Regulatory Updates and Process Evaluation
Start: 2023-11-02T13:23:00Z
End: 2023-11-02T13:23:50.000Z
Location: BrightTALK
Rating: 4

Inovalon is a leading provider of cloud-based solutions empowering data-driven healthcare. The Inovalon ONE® Platform brings together national-scale connectivity, real-time primary source data access, and advanced analytics to enable improved clinical outcomes and economics across the healthcare ecosystem.

The Current Healthcare Landscape is driving the need for more data, a cohesive/comprehensive data strategy and strategic partnerships. 

Watch our Customer Congress 2023 session to learn how having access to the right data and records allows for better interoperability as well as can see advantages such as: 

Budget and resource optimization 

Reduction of duplicative efforts and fragmented member experiences and touchpoints 

Reduction of member abrasion 

Reduction of provider abrasion and streamlined provider requests 

Increased collaboration and opportunity for employee growth and development 

Join our speakers as they take you through use cases and the capabilities of Inovalon’s Healthcare Data Lake and Electronic Records on Demand, and how the abilities within can improve your interoperability for a fuller member picture.

Supercharge Your Interoperability Strategy for a Full Member Picture

In today's dynamic healthcare landscape, access to timely and comprehensive data is crucial for informed decision-making. However, health plans often grapple with managing various pain points, from data accessibility to a lack of expertise and support. Join our webinar to discover how you can resolve these challenges and harness the full potential of your healthcare data to unlock timely, comprehensive, and holistic insights.
You’ll learn how to:
- Gain the competitive edge with 24/7 access to both administrative and quality data
- Navigate the complexities of healthcare data with ease
- Leverage these insights to drive more effective decision-making and care delivery.

Navigating Healthcare Data Challenges for Health Plans

Combining the efforts of quality measurement and risk adjustment teams through a single analytics-based program can transform health plan operations, performance, and costs – elevating internal collaboration to drive better results and happier members. 

Jim Clement, Vice President, Product & Services, Inovalon | Moderator 

Leah Hannum, Director, Government Funding Operations, Blue Cross of Idaho 

Jocelyn Hines, M.D., Medical Director, Inovalon 

Kristopher Volrath, Senior Vice President, Product, Inovalon

A Case Study: Putting Integrated Quality and Risk Insights into Focus

To thrive in today’s constantly evolving healthcare ecosystem, labs must ensure that they’re billing the right payer(s) for every patient claim. But how?
Incomplete and out-of-date patient information often leads to billing and claims management struggles.  
Find out how data can help you achieve:
Automation - Enhance efficiency with streamlined claims processing
Verification - Automatically find all applicable coverage, even without complete patient information
Reimbursements - Find out how a collections agency increased collections by 10% with our software

Uncovering Data to Improve Payer Accounts: A Case Study

o There’s no easy way to manually keep up with changes in eligibility and coverage. With the right tools, your team can handle eligibility verification for all payers with ease using just one user-friendly interface.
In this on-demand webinar, you’ll learn how to bill the correct payer every time, get complete visibility of insurance eligibility, and boost efficiency and revenue with automated revalidation. Discover an all-payer health insurance eligibility software that will help your organization:

Fast-track eligibility checks - A front-end workflow that standardizes and automates the eligibility process for your team.
Reduce claims denials - A comprehensive, real-time view of eligibility eliminates the risk of submitting inaccurate information.
Maximize efficiency - Batch processing allows staff to enter multiple patients and check multiple payers all in one quick step.

Save Time and Money with Streamlined Eligibility Verification

If you have more than one claims management system, your billers are likely spending unnecessary time remembering passwords, flipping between payer portals, and handling denials, audits and appeals. Try an integrated approach to claims management. During this webinar, you'll learn how to:
• Bring it all together with the first all-payer claims management dashboard
• Reduce denials with a 99% or better clean claims rate
• Save time with eligibility verification during claims upload

Claims Management, Connected: One Login, All Payers

Traditional risk adjustment solutions aren’t cutting it anymore. Health plans are too often stumbling between limited transparency, inadequate regulatory expertise, and expensive, siloed internal approaches.  

SaaS-based data analytics are the answer. Your health plan must have the right solution in place to set your team – and more importantly, your members – up for success. In this webinar, our industry experts will share how to go from confusing, disconnected risk program management to a streamlined, data-driven program that can be configured to meet your plan’s unique needs, ensure compliance, and drive risk score accuracy.

Achieving An Easier, Faster, Smarter, More Efficient Risk Score Accuracy Program

Incomplete and out-of-date patient information often leads to billing and claims management struggles. How can you ensure that you’re billing the right payer(s) for every patient claim? Discover ways to strengthen your results in three key areas:

-- Automation: Enhance efficiency with streamlined claims processing
-- Verification: Automatically find all applicable coverage, even without complete patient information
-- Reimbursements: Find out how a collections agency increased collections by 10% with our software

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.  

- 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

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

Members are looking for a high-quality, streamlined experience. For health plans to achieve this, they must engage their provider partners to close care gaps, coordinate care, and meet member expectations. Collaboration and partnerships between payers and providers can ensure health plans can deliver the experience they want for their members — and their members want from them. Experts from Quartz, a Midwest-based, provider-owned health plan, share how strong provider partnerships deliver value for payers and health systems alike. Through a collaborative partnership with the payer, providers can focus on patient care rather than insurance red tape; and payers see the benefits through high customer satisfaction, which translates to robust health plan ratings and enrollment growth. Learn how a health plan engages its provider partners to overcome friction points, deliver a streamlined experience, achieve robust plan ratings, and move along the path to value.

How Health Plans Can Deliver Value Through Provider Engagement

Insurance Discovery identifies all available insurance coverage for patients, reducing uncompensated care and underpayments in healthcare. Find more coverage to reduce self-pay patients, charity and bad debt write-offs.

Insurance Discovery for Ambulatory Service Providers

How are you preparing for the No Surprises Act?

CMS’ new law impacts any provider or site of care that delivers emergency services, post-emergency stabilization, and/or non-emergency services provided at in-network facilities.

If that describes your organization, we’d like to share our on-demand webinar with you. In it, we help providers and sites of care better understand:

• How the law impacts your organization
• Common challenges and questions about the law
• Ways to ensure compliance, optimize revenue, and increase claims accuracy

Navigating the No Surprises Act

Quality measurement and risk adjustment program integration can have a significant impact on a health plan’s member satisfaction and retention rates, as well as provider engagement. Combining the efforts of these traditionally siloed teams through a single analytics-based program can transform health plan operations, performance, and costs – elevating internal collaboration to drive better results and happier members by enabling plans to:

• Coordinate quality and risk program needs to reduce duplicative outreach to both providers and members
• Share analytically-identified opportunities that enable providers to address both patient care and documentation needs in the same care encounter
• Streamline provider messaging to ensure reporting and documentation requirements are clear
• Share data and results with providers that demonstrate the value of quality and risk program efforts to foster ongoing engagement

In this webinar, our dynamic slate of panelists will explore how innovative healthcare technologies are now empowering health plans to improve outcomes and efficiency through an integrated approach. You’ll learn best practices for undertaking a unified analytics strategy and hear about one health plan’s journey to fostering organizational change in support of an integrated program. Attendees will also get a first-hand look at how Inovalon is empowering payers to improve member satisfaction and accelerate quality and risk adjustment gap closure with a complete, holistic patient view and seamless information sharing with providers.

Case Study: Achieving Integrated Quality and Risk Program Excellence

As risk adjustment models and regulations evolve, it’s even more important for payers to resolve issues like lack of transparency into member data and risk scores, disjointed and siloed processes, and more.

Patrick O’Hara - Moderator – Senior Solutions Engineer 

Kate Marta, RN, BSN – Vice President, Clinical Quality, Training & Oversight 

Lalith Mehta – Vice President, Data Anlaytics

Data Management

Risk Analysis

Risk Assessment

Risk Adjustment

Data

User Data

Data Analysis

Data Analytics

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

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Inovalon