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IMPROVE CAHPS

RISE National 2022 in Nashville

As the #1 trusted source for risk adjustment, quality, Stars and beyond, RISE National 2022 was held in Nashville this month. Professionals of all levels in the Medicare Advantage and ACA market were in attendance. Follow their hashtag #RISENational2022.

Here are some thoughts from attendees.

Kyle Silvestro, CEO & founder of SyTrue, which modernizes payer workflows to reduce costs and increase efficiencies

RISE National 2022 was a fantastic opportunity to hear from insurance leaders about meaningful issues facing the healthcare industry, from COVID-19 to Medicare Risk Adjustment, and care equality. The opportunities for engagement and face-to-face interactions launched creative discussions targeting solutions and cost savings. A must-attend event for next year.

Carissa Stajnrajh, Vice President of Clinical Strategy of Insightin Health which offers a cloud-based platform that integrates disparate data streams to identify real-time insights enabling health plans to deliver personalized, consumer-centric healthcare experiences.

CMS’ urge to advance health equity and incorporate social determinants data in the risk adjustment model is a lofty goal for the industry. Incorporating data on SDoH into a quality measure may be a faster and easier solution, but the way plans utilize their data needs to change. Connecting data in a way that transitions from check-the-box reporting to actionable insights is the key to understanding member issues, barriers, and preferences to drive personalized Next-Best Actions to improve their overall health and quality of life.

Lynn Carroll, COO of HSBlox, which assists healthcare stakeholders at the intersection of value-based care and precision health

There was great dialogue and enthusiasm with respect to Social Determinants of Health. Attendees noted the COVID-19 impact on conferences, with many discussing its revelations about health inequities. In general, there seemed to be heightened awareness of the need to incorporate home and community-based services as a part of the push to value-based programs, with CMS pushing for all payments to be under value-based contracts by 2030. In tandem, there was lively discussion about the ACO REACH Model and improving the care for Medicare beneficiaries from underserved communities.

Yassin Sallam, vice president of Dina, which provides an AI-powered care coordination platform and network that support hospitals and health systems, ACOs, and health plans as they transition to home-centered care

Supplemental benefit design drives Medicare Advantage (MA) member acquisition and retention in an increasingly competitive MA payer landscape. Evidence shows that specific supplemental benefit activations reduce total cost of care. One exciting example merges clinical and dental silos, activating dental services for chronic disease cohorts to positively impact quality of life and total cost of care. More broadly, mitigating SDoH challenges has real impact on a community, but requires efficient candidate identification and service deployment to be successful. The demand for technology to help payers/providers address these challenges in care delivery, quality, and outcomes remains strong.