Starting in 2020, CMS plans to calculate risk adjustment payments using a new formula. The model is designed to reduce incentives for payers to enroll healthier members, by giving them reimbursement for higher-risk and costlier beneficiaries. Since risk scores determine payment, what does this mean for ACOs and Medicare Advantage organizations?

This webinar makes sense of the new scoring methodology. With a simple, common sense approach, the speaker breaks down the risk methodology and ACO track changes. Attendees will learn how to handle what feels like overwhelming adjustments today, while getting actionable advice to prepare for the future.

At the conclusion of this webinar, attendees will:

  • Understand changes to risk adjustment methodologies and programs, including “pathways to success” and telehealth additions for Medicare Advantage 
  • Recognize the impact on documentation and payment 
  • Ensure compliance through audits
  • Recognize best practices for capturing HCCs today while planning for the future 

Takeaway:

As part of the presentation, attendees receive a free risk adjustment flyer, HCCs and Clinical Documentation: The Core of Risk Adjustment, for instant download and sharing. 

Sonia Trepina, MPA, Director of Ambulatory CDI Services for Enjoin

Sonia has over 20 years of experience in program development and management, with 14 years specific to health care revenue cycle.  She has a broad understanding of the healthcare billing environment and extensive experience in clinical documentation improvement (CDI) methodologies including CDI improvement methods, process improvement and redesign, operations management, data analysis, training and education, and project and change management.

Brett B. Senor, M.D., CRC, CCDS, Medical Director for Enjoin

Dr. Senor is board-certified in Internal Medicine and provides education and support for Enjoin clients in both the inpatient and ambulatory setting. He has served as a hospitalist and physician advisor for a large metropolitan healthcare system in North Carolina and has extensive experience in HCC’s and risk-adjustment.