Pulse8™ to Address: Quality Management with Risk Adjustment for ACA Commercial Markets at the Upcoming RISE Healthcare Insurance Exchange Summit

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Pulse8’s Kari Hadley, Senior Director, Medicaid and Quality Products, and Candy Simmons, MSN, RN, Senior HEDIS®/Quality Data Analyst, will discuss how to coordinate Quality Management with Risk Adjustment for the ACA Commercial Market, on October 17, 2016 at 1:45 pm.

Regulations for quality measurement and risk adjustment are increasing and the financial impact for health plans are progressively driving accountability and profitability with payments, penalties, and bonuses. In order for health plans to manage this complexity and stay profitable, Risk and Quality departments will need to streamline their processes, employ best practices for data capture, and use strategic interventions to improve program outcomes, efficiency, and results.

Combining quality programs with efforts aimed at documentation and coding can be difficult, so having a coordinated road map is key. The ideal approach uses predictive analytics that identify the likelihood of closing quality gaps, prioritizes the revenue impact of addressing each quality metric, and evaluates providers and medical groups for both clinical performance and coding efficacy.

During this presentation, attendees will get a better understanding of risk and quality programs and how they can work together to close gaps in care, including the following:

  • The Financial Impact of Commercial Risk Adjustment (CRA) and Quality Programs
  • Synergies between Quality and Risk Adjustment for ACA populations
  • Keys to success in integrating Risk and Quality Programs
  • Closing Gaps using an integrated approach for Risk and Quality

About Pulse8:
Pulse8 is the only Healthcare Analytics and Technology Company delivering complete visibility into the efficacy of Risk Adjustment and Quality Management programs, enabling health plans and at-risk providers to achieve the greatest financial impact in the ACA Commercial, Medicare Advantage, and Medicaid markets. By combining advanced analytic methodologies with extensive health plan experience, Pulse8 has developed a suite of uniquely pragmatic solutions that are revolutionizing risk adjustment and quality. Pulse8’s flexible business intelligence tools offer real-time visibility into member and provider activities so our clients can apply the most cost-effective and appropriate interventions for closing gaps in documentation, coding, and quality. For more company information, please contact Scott Filiault at (732) 570-9095, visit us at http://www.Pulse8.com, or follow us on Twitter @Pulse8News.

About Healthcare Education Associates:
Healthcare Education Associates (HEA) is a division of Financial Research Associates, LLC. HEA is a resource for the healthcare and pharmaceutical communities to improve their businesses by providing access to timely and focused business information and networking opportunities in topical areas. Offering highly targeted conferences, Healthcare Education Associates positions itself as a preferred resource for executives and managers seeking cutting-edge information on the next wave of business opportunities. Backed with over 26 years of combined conference industry experience, the producers of HEA conferences assist healthcare professionals, actuaries, attorneys, consultants, researchers and government representatives in their professional endeavors. For more information on upcoming events, visit us online: http://www.healthcare-conferences.com

About Resource Initiative and Society for Education:
RISE is the first national association totally dedicated to enabling healthcare professionals working in organizations and aspiring to meet the challenges of the emerging landscape of accountable care and health care reform. We strive to serve our members on four fronts: Education, Industry Intelligence, Networking and Career Development. To learn more about RISE and to join, visit us online: http://www.rasociety.org

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Scott Filiault, Chief Revenue Officer
Pulse8 Inc.
+1 732.570.9095
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Lauren DiPaul, Marketing Coordinator
Pulse8 Inc.
410.928.4218 124
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