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RISE National 2025 kicked off today, bringing together healthcare leaders, policy experts, and industry innovators to explore the evolving landscape of Medicare Advantage, risk adjustment, and compliance. As the premier event for healthcare professionals focused on government-sponsored health plans, the conference set the stage for thought-provoking discussions on regulatory changes, payment integrity, and strategies for improving member outcomes.
What is RISE National?
RISE National is the leading conference for professionals in managed care, offering in-depth discussions on policy updates, regulatory compliance, risk adjustment, and quality improvement. Attendees include health plan executives, government agencies, and solution providers collaborating to shape the future of healthcare for Medicare Advantage and Medicaid beneficiaries. The conference is a hub for learning about emerging regulations, risk mitigation strategies, and innovations in member engagement that drive positive health outcomes.
Key sessions and takeaways
Opening keynote: Navigating the future of healthcare policy: The conference opened with a keynote on the shifting regulatory landscape and its impact on Medicare Advantage and Medicaid programs. Experts weighed in on the latest updates from CMS and the importance of proactive compliance strategies. The consensus? Organizations that stay ahead of evolving policies will be best positioned to deliver quality care while maintaining financial stability.
Risk adjustment and payment integrity: This session provided a deep dive into changes affecting hierarchical condition categories (HCC) coding, data validation audits, and the impact of AI on risk adjustment strategies. Panelists emphasized the growing role of predictive analytics in optimizing risk scores and ensuring compliance with CMS guidelines.
Member engagement and Social Determinants of Health (SDOH) Speakers highlighted innovative programs aimed at reducing disparities in care by leveraging community partnerships and targeted outreach. With CMS prioritizing health equity, organizations are increasingly looking at ways to integrate SDOH data into their care models to improve member satisfaction and outcomes.
Looking ahead
Day one of RISE National 2025 reinforced the urgency of staying ahead of regulatory changes while leveraging technology to drive efficiency and improve member care. As we continue engaging with industry leaders, we’re eager to explore how AI, predictive analytics, and proactive compliance strategies can help organizations navigate the complexities of government-sponsored healthcare programs.
Stay tuned for more updates from RISE National, and if you’re attending the conference, let’s connect!
Greg Hoffman with Paubox customer Sprinter Health.
