RISE

Explore why industry veterans deem the current climate the most challenging yet and gain practical insights to optimize performance under these conditions during this #webinar with Advantmed's VP of Analytics & MMR Solutions, Jimmy Liu.

Although HHS and CMS say the proposed policies would increase value-based care and expand access to behavioral and oral health care, if finalized, physicians would face a cut in pay for the fifth year in a row. It also includes several provisions that would impact Medicare Advantage. The 2,248-page proposed rule will be published in the Federal Register on July 31. Comments are due by September 9. #MedicareAdvantage #valuebasedcare #behavioralhealth #riskadjustment

We are less than a month away from The RISE Medicare Product Design Master Class! Check out some of the sessions and speakers you'll hear when you join us August 5-6 in Orlando. PLUS! The venue is a short walk away from the fun-filled world of Disney Springs® where you can discover more than 150 dining, shopping, and entertainment venues. What are you waiting for? See you in Orlando! https://lnkd.in/gCeKS8g9 #ProductDesign24 #MedicareAdvantage

#CompliancePalooza2024 will feature insights on the 2025 Medicare Advantage Final Rule, audit readiness techniques, health equity analysis of utilization management, and network adequacy. The virtual agenda is jam-packed with hot topics, and you can watch them all from the comfort of your home or office on September 3-4.

CMS on Wednesday released the 2025 Hospital Outpatient Prospective Payment System and Ambulatory Surgical Center proposed rule. Here is an initial look at what’s included in the 984-page proposal. The proposed rule, which will be published in the Federal Register on July 22, affects roughly 3,500 hospitals and 6,100 ASCs. Comments on the proposal are due to CMS by September 9.

On the 23rd anniversary of 9/11, Heather "Lucky" Penney will speak at #RISEWest2024 about her preparation for a suicide mission that day and what it means to be a hero. In this interview, she explains why she believes that despite the anger and divisiveness across the country, the American Dream and the DNA of the greatest generation is still alive and well within us.

RISE reviews the latest #SDoH headlines: • HHS invests $27.5M in women’s behavioral health • Report ranks most socially responsible hospitals • Report: Patient experience scores on the rise, disparities remain

RISE reviews the latest regulatory headlines: • Federal gender nondiscrimination rule put on hold • Fed judge pauses CMS caps to Medicare Advantage brokers, agents pay • OIG: Independent Health Associates, Inc. received $7M in overpayments in 2016 and 2017 • GOP lawmakers urge watchdog agencies to review potential fraud in ACA plans • OIG to investigate MA’s use of prior authorization for post-acute care • HHS, FBI warn health care providers about phishing, ransomware attacks • HHS OCR settles HIPAA Security Rule failures for $950K

An in-depth report by the Wall Street Journal reveals that #MedicareAdvantage insurers were paid $50 billion from 2018 to 2021 for thousands of questionable diagnoses. The newspaper analyzed billions of Medicare records and discovered in some cases patients never received subsequent care for their supposed diagnoses and, in others, doctors say patients couldn’t possibly have the condition.

One of the biggest lessons Laedtke says he’s learned in life is to advocate for himself. “It’s not about fighting with medical professionals, but I do tell them we need to take this seriously. What can we do about this? Please don’t brush this off,” he says. Hear more from Jonathan Heider Laedtke, a Paralympic swimmer and inclusivity expert, during his keynote address at #RISEWest2024, September 11-13 in Colorado Springs, CO.