Translating Risk into Revenue: Strategies for Risk-Adjusted Markets

HFMA Webinar

Event Details

  • April 26, 2017
  • 12:00 pm - 1:00 pm
  • Online webinar; 12:00 - 1:00 pm PDT
  • FREE WebinarRegistration Fees

REGISTRATION

Register at HFMA Northern California WebEx

DATE & TIME

Wednesday, May 24, 2017 12:00 – 1:00 pm PDT

SPEAKERS

Brad Hefland, Managing Director HealthScape Advisors

Brad participates in a diverse number of strategic and operational client engagements. His areas of expertise include enterprise growth and financial planning, service line distribution for integrated delivery networks and health reform preparedness for emerging payment models, population health management and insurance exchanges.

Brandon Solomon, Director HealthScape Advisors

Brandon’s expertise includes the development of growth strategies, planning and managing business implementations and advising clients operating in regulated markets.  Over the course of his career, Brandon has worked extensively with commercial health plans, government contractors, pharmacy benefit managers and other ancillary organizations.

 

AUDIO INFORMATION:

***This online education event will use a ONE-WAY AUDIO BROADCAST through the participants’ computer speakers. A computer sound card and a headset or speaker is required. Participants have the ability to request for an audio connection by phone during the live broadcast.

Participants can communicate with the host, speaker and panelists using tools such as the chat box and Q&A.***

SUMMARY

Health plans are facing a transformative financial period as more of their revenue shifts from being comprised of underwritten premiums collected, to include the concept of risk adjustment. In turn, more provider contracts include risk adjustment, either as a primary component of a value based arraignment or as additional incentive payments for complete and accurate coding documentation. Risk adjustment is necessary to align reimbursement with the risk of the population being managed by the plan. This dependence on encounter documentation, and the substantiation of the submitted coding within the medical chart, means that physicians’ ability to accurately and completely code a patient directly impacts their own, as well as the health plans’, bottom line. With health plans facing greater regulatory scrutiny and False Claims Act allegations for focusing on increasing code capture without assessing accuracy, it is imperative for health systems establish the proper controls necessary to remain compliant while ensuring accurate risk-based financial reimbursement.

Learn how health systems who understand this paradigm and can prove their ability to achieve complete and accurate documentation have a strategic advantage in negotiating with health plans. Achieving this strategic advantage requires health systems to take control of their own workflows, have the proper control in place to ensure coding accuracy, and not be solely reliant on numerous health plans to push data and requests in a variety of formats that tax different parts of the organization.

 

Those attending the webinar will learn the following:

  • Understand the financial and compliance implication of diagnostic coding practices under risk-adjusted and risk-bearing arraignments
  • How diagnostic completeness can become a competitive advantage for a health system
  • Best practice methodologies for improving coding diagnostic practices and how to address payer specific initiatives that cause operational fragmentation for the health system
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