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Improving risk adjustment: Integrating internal and external innovations

Health plans are increasingly investing in improving their risk adjustment programs—by integrating new technologies or launching new projects—to prepare for RADV and OIG audits. Regulators call on health plans to act, avoid penalties, and rebuild trust with authorities, providers, and members by focusing on key priority areas like interoperability, data accuracy, and provider/member experience.

Watch the webinar on-demand as we highlight key considerations for combining in-house capabilities with vendor partnerships to strengthen risk adjustment results and compliance. We will discuss how health plans across different markets and sizes have devised strategies to integrate vendor support with in-house capabilities to increase efficiency, reduce internal burden, and improve results including data accuracy.

You'll learn about:

  • Addressing resource constraints to focus on high value opportunities
  • Integrating technologies to strengthen data accuracy and speed
  • Leveraging insights on plan trends and industry benchmarks
  • Measuring the impact of internal and external programs

Presenters

Tracey Bradberry - Vice President, Business Excellence, Cotiviti
Tracey is responsible for the data governance, data science, business intelligence, innovation and business partnerships teams in Cotiviti's Retrieval Operations. Her professional experience includes leadership in customer operations, compliance and auditing, business partnerships, and end-to-end operations from data management to analytics, development, client success, and reporting.
Katie Devlin, DHSc, MS, CPHIMS - Vice President, Interoperability, Cotiviti
Katie is responsible for creating an enterprise-wide health data exchange strategy to address our client’s unique business needs, while reducing provider abrasion, maintaining regulatory compliance, and optimizing value. She oversees all initiatives related to digital health data acquisition, ingestion, storage, and normalization, including the expansion of Cotiviti’s electronic health data networks and strategic partnerships.
Katie Sender, MSN, RN, PHN, CRC - Vice President, Clinical and Coding Services, Cotiviti
Katie is responsible for leadership and management oversight of teams spanning the globe to ensure optimal client outcomes and service delivery through management of key performance indicators related to clinical and coding solutions. She is responsible for driving strategic direction, operational efficiency, product quality and client alignment for Risk Adjustment coding, HEDIS® medical record review and abstraction, as well as revenue cycle management operations.