This year’s virtual Risk Adjustment Forum was filled with a variety of top-notch speakers that represented a breadth of health plan, provider, and regulatory positions.
There were many important points made throughout the conference. Here are a couple of highlights:
- CMS continues to make waivers for dealing with COVID-19, and chief among them are the new telehealth rule expansions. Telehealth is being expanded to a variety of conditions and a variety of providers that can use it to certify risk-adjustable conditions. Go here to keep up to date: https://www.cms.gov/about-cms/emergency-preparedness-response-operations/current-emergencies/coronavirus-waivers
- Best Practices with Telehealth were shared in multiple presentations.
- Analytics and NLP were still prominent issues for identifying opportunities.
However, the biggest take-away for us from the conference was that the key thing driving Risk Adjustment in 2020 is, in fact, Provider Engagement.
- Multiple presentations discussed best practices in incentives, from structures to delivery methods and calculations
- Something that was more prevalent than has been in the past was a focus on workflows and how to engage providers and their staff in more real-time coding and documentation recapture
- Our own Director of Business Development, Will Dukes, led a discussion on the Risk Adjustment Playbook, yet most of what the health plan participants focused on was the importance of building trusting relationships with the providers and their staff.
This seems a fitting transition into the next Rise conference, the Payer/Provider Engagement and Contracting Summit. Obviously, we expect this conversation to expand beyond Risk Adjustment, but certainly the discussion of incentives, clinical documentation, and simplifying workflows will be front and center.
We’ll be leading another discussion highlighting the lessons one of our clients has learned over the past few years regarding incentive structure and simplifying workflows there.
If you weren’t able to attend the Risk Adjustment Forum and would like to discuss some of the additional resources from there, feel free to reach out to our team.