Significant improvements in both STAR ratings and Risk Adjustment revenue for many Medicare Advantage health plans come from increased compliant clinical documentation submissions. This requires an increased level of engagement from their Primary Care Provider networks that is often difficult to achieve.
For HealthFirst Health Plan, incentives provided some improvement, but incentives were not enough. However, when they introduced strategies that improved the workflows between their team and PCP offices for the 2019 reporting year, they saw a 30% increase in compliant submissions for Quality Gaps and a 41% increase in compliant submissions for Risk Adjustment. In this webinar, we discuss in detail the steps by which Health First developed and executed on their PCP engagement strategy.
• Break down silos between Risk Adjustment, Quality, and Pharmacy
• Reduce provider friction and abrasion
• Simplify the clinical documentation submission process
• Reduce the time required to close gaps and give feedback to the PCPs (by 83%)
• Take key lessons learned about incentives and use them to shape the 2021 incentive contracts
See how you too can improve the quality of primary care engagement to expedite internal procedures and processes resulting in compliant clinical document submissions that significantly improve STAR Ratings and Risk Adjustment revenue.
Rachel Musacchio, Director of Revenue Operations, Health First Health Plan
Rachel Musacchio is the recently appointed Director of Revenue Operations for Health First, a Medicare Advantage health plan provider located in Central Florida. Rachel started her career with Health First as a Risk Adjustment Analyst and has served as the Supervisor of Quality Comprehensive Health Assessments. She has been instrumental in the development and implementation of Health First’s successful strategy for provider engagement to increase the quantity and quality of clinical documentation submission, and in her new role will oversee its expansion into medication adherence measures.
Will Dukes, Director of Business Development, iCare Intelligence
A farmer by birth and biologist by training, Will Dukes is the Director of Business Development for iCare Intelligence, a firm dedicated to Provider Engagement in Value Based Care. Formerly an award-winning public school teacher, Will’s advanced degrees in Education and Communication and Master’s in Global Business Administration and unique experience allows him to combine skills in systems approach, data analysis, and education to improve communications not only between iCare and their payer clients, but between payors and providers as well.
Who Should Attend:
Medicare Advantage and Other Value Based Contracting Health Plans
Senior Management from:
• Value Based Care
• Revenue
• STARs
• Risk Adjustment
• Pharmacy Directors/Managers
iCare Intelligence is dedicated to the power of provider engagement. Its platform aggregates health care data (Financial, Risk Adjustment, HEDIS/Quality, Pharmacy and more) from multiple sources and delivers it to the provider in an intuitive, actionable platform that offers a real-time, bi-directional messaging system for closing gaps in care. This saves PCPs time and resources, and enables better outcomes. Coupled with a fully customizable incentives module that calculates and displays progress towards care measures and performance goals, iCare can dramatically reduce average time to close gaps in care, increase the quantity of submissions, and improve the quality of and compliance of clinical documentation.
