Provider Coding Accuracy in Commercial Value Based Contracts: Impact on Risk Adjustment and Performance Metrics

      
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Provider Coding Accuracy in Commercial Value Based Contracts: Impact on Risk Adjustment and Performance Metrics 
 
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Overview
As the prevalence of commercial value based contracts grows, so too does the variability of a provider's overall compensation. In value based contracting, providers are "measured" on certain performance metrics that will dictate ho much they are ultimately paid. In this environment, risk adjustment plays an integral role in determining the provider's "measurement" of financial performance.

For value based contracts to be equitable to all parties, risk adjustment should endeavor to accurately capture the change in the underlying population's morbidity to effectively measure the provider's true cost impact on its attributed population.  Accurate data is critical in this regard to deliver accurate risk adjustment. The accuracy of risk adjustment is dependent on a provider's capability in capturing the most accurate diagnosis information on patients. Improving risk adjustment accuracy can significantly change a provider's calculated measurement on performance metrics.

Please join us Wednesday, December 13th, 2017 at 1 PM Eastern as Milliman's Rong Yi, PhD explores various aspects of risk sharing as it pertains to value-based contracting for commercial lines of business and addresses the relationship between data accuracy, risk adjustment and measurement of performance metrics in the HealthcareWebSummit event: Provider Coding Accuracy in Commercial Value Based Contracts: Impact on Risk Adjustment and Performance Metrics.
Learning Objectives

After attending this webinar, attendees will be able to:

  1. Understand the relationships between data accuracy, risk adjustment and measurement of performance metrics.
  2. Explore various aspects of risk sharing as it pertains to value-based contracting for commercial lines of business.
  3. Identify common claim data issues.
  4. Quantify the potential impact of rectifying data accuracy issues.
  5. Consider how provider organizations can improve data accuracy.
  6. Engage in interactive learning through online question submission, attendee feedback and opportunity for follow up questions, and networking with attendees, faculty and other professionals through dedicated LinkedIn group.
Who Should Attend

Interested attendees would include:

  • C-Suite Executives
  • Provider Contracting Executives and Staff
  • Provider Network Executives and Staff
  • Analytics Executives and Staff
  • Managed Care Executives and Staff
  • Medical Claims, Billing and Coding Executives
  • Medical Directors
  • Finance Executives and Staff
  • Planning and Strategic Executives and Staff
  • Actuarial Executives and Staff
  • Business Intelligence Staff
  • Other Interested Parties

Attendees would represent organizations including:

  • Provider Networks
  • Accountable Care Organizations
  • Hospitals and Health Systems
  • Integrated Delivery Systems
  • Health Plans
  • Third Party Administrators
  • Business Process Organizations
  • Life Science Organizations
  • Solutions Providers
  • Associations, Institutes and Research Organizations
  • Media
  • Other Interested Organizations
Registration
  Individual Registration Fee: $195. Post-event materials, with video of slides synchronized with speaker audio, plus presentation pdf file: $45 for attendees; $260 for non-attendees after the event. Register online or download the event flyer.
 
 
 
Register Now   Click here to register or call 209.577.4888. Corporate Site licensing also available. We look forward to your attendance!
 
 
Faculty
 
Rong Yi, PhD

Rong Yi, PhD
Principal and Healthcare Management Consultant, Milliman

  Rong is a Principal with the New York office of Milliman. She joined the firm in 2009.

Rong has extensive experience in healthcare analytics, especially in the fields of in risk adjustment and predictive modeling. She has worked with private insurers, providers, employers, government agencies, and researchers in the United States and other parts of the world. She is a frequent speaker at professional and academic conferences.

Rong has done pioneering work in a number of areas, including state-based risk adjustment programs for the commercial markets and for the uninsured population, risk-based provider contracting and profiling, risk-adjusted episodes of care, and predictive models for a variety of business applications. She works with clients to implement analytic methodologies and tools into their business process, and in this capacity assists clients to develop business rules and operational guidance to ensure program operational success. Most recently, she is the lead consultant for the Massachusetts ACA risk adjustment program, and led the development, implementation and operations of the Massachusetts state-based risk adjustment methodology for the commercial individual and small group market.

Before joining Milliman, Rong was a major contributor to commercial and governmental risk adjustment systems in wide use today.

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