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Risk Adjustment and Encounter Data Changes – Webinar on demand

Risk Adjustment And Encounter Data Changes – Webinar On Demand

Since risk adjustment’s introduction in the Medicare Advantage (MA) program, the Centers forshutterstock_169176878-webinar-button.jpg Medicare and Medicaid Services (CMS) has calculated risk scores using diagnoses submitted by MA plans in the Risk Adjustment Processing System (RAPS) format. However, CMS is moving away from the RAPS format to 837 encounter data (EDS) for Medicare risk adjustment factor determination. Beginning in 2016, CMS will blend encounter data-based risk scores with RAPS-based risk scores and eventually completely replace RAPS data.

It is now a business imperative for plans to have a robust encounter submission strategy in place to preserve revenue in 2016 and improve revenue in the future. Click here to view this free webinar originally presented to members of ACAP on the move to encounter data, how this could affect plans, and how to build a strategy that ensures success.

Marc Ryan

Marc S. Ryan serves as MedHOK’s Chief Strategy and Compliance Officer. During his career, Marc has served a number of health plans in executive-level regulatory, compliance, business development, and operations roles. He has launched and operated plans with Medicare, Medicaid, Commercial and Exchange lines of business. Marc was the Secretary of Policy and Management and State Budget Director of Connecticut, where he oversaw all aspects of state budgeting and management. In this role, Marc created the state’s Medicaid and SCHIP managed care programs and oversaw its state employee and retiree health plans. He also created the state’s long-term care continuum program. Marc was nominated by then HHS Secretary Tommy Thompson to serve on a panel of state program experts to advise CMS on aspects of Medicare Part D implementation. He also was nominated by Florida’s Medicaid Secretary to serve on the state’s Medicaid Reform advisory panel.

Marc graduated cum laude from the Edmund A. Walsh School of Foreign Service at Georgetown University with a Bachelor of Science in Foreign Service. He received a Master of Public Administration, specializing in local government management and managed healthcare, from the University of New Haven. He was inducted into Sigma Beta Delta, a national honor society for business, management, and administration.

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