Choose Your Roundtable Experience

Explore the roundtable topics and plan your rotations on Tuesday at 12:00pm in the Exhibit Hall

Tuesday, March 24
12:00pm - 1:00pm
Exhibit Hall 

Pull up a chair for one of the most interactive sessions of the conference. In this fast-paced, 60-minute experience, you’ll rotate through three roundtable presentations led by health care’s top technology and solution innovators. Browse the topics below and plan your rotations.

Roundtable 1: Full Court Press: Going from Defense to Dominance in Risk Adjustment

  • The Unlinked CRR Shutdown. Rethinking the supplemental submission game.
  • RADV Goes to Overtime. Underperforming during your HHS RADV or trying to figure out your game plan for the intensified CMS RADV scrutiny and extrapolation? Let’s discuss proven strategies to take you from defense to dominance.
  • Winning the Rebuttal Battle. Strengthening your HHS RADV performance through targeted reviews.

Roundtable 2: Reimagining Risk Adjustment: Strategies to Reduce Waste, Drive Accuracy, and Improve Member-Centered Outcomes

  • Eliminating Administrative Waste to Reinvest in Member Care: Identify the key drivers of inefficiency in risk adjustment and strategies to streamline operations, reduce manual workloads, and reallocate resources toward initiatives that directly impact member outcomes.
  • Leveraging Automation to Amplify Human Expertise: How AI and automation can handle high-volume, low-variation tasks, enabling certified coder teams to focus on complex cases, while ensuring automation enhances human decision-making.
  • Advancing Accuracy, Audit Readiness, and Scalability: Strategies for achieving consistent, explainable outcomes that stand up to audits, adapt to evolving regulations, and build workflows that are both defensible and scalable in today’s environment.

Roundtable 3: Advancing Post-Acute Care through OneHome’s Reimbursement Innovation and Operational Excellence

  • Explore reimbursement strategies and partnership models that help enable providers to deliver high-quality, patient-centered post-acute care in a challenging financial environment.
  • Examine practical administrative and operational approaches to help providers overcome key post-acute care constraints while maintaining strong performance and sustainability.
  • Review collaborative, plan-provider strategies that strengthen care continuity, prioritize patient needs and improve outcomes across the post-acute care continuum.

Roundtable 4: AI Can Scale. But Can It Defend? The New Hybrid Intelligence Risk Adjustment Operating Model

  • AI on the Frontlines: How automation speeds coding and where blindspots could trigger audit exposure.
  • Humans in the Driver’s Seat: Why certified coders remain the ultimate risk control in risk adjustment.
  • ROI That Counts: What success looks like beyond productivity, including compliance confidence, RAF stability, and operational predictability.

Roundtable 5

Roundtable 6: A Guideline Driven Approach to Reducing Dermatology Specialty Spend

  • Why dermatology care frequently escalates to biologics despite clear guideline recommendations.
  • How health plans can redirect eligible members before unnecessary escalation occurs.
  • How value based specialty models can reduce dermatology spend while preserving clinical outcomes.

Roundtable 7: Inside 20 Years of Risk Adjustment Audits Experience: What Works, What Doesn’t, What’s Next

  • Identify key insights from 20 years of audit experience to strengthen risk adjustment programs and improve preparedness for audits such as Initial Validation Audit (IVA), Office of Inspector General (OIG) mock audits, and Medicare Advantage Risk Adjustment Data Validation (RADV).
  • Examine common audit findings and pitfalls that lead to unsupported diagnoses, documentation deficiencies, and payment exposure—and discuss practical strategies to mitigate these risks before regulators identify them.
  • Understand key audit timelines and preparation milestones across IVA, Mock OIG, and MA RADV processes to help health plans align internal reviews, chart retrieval, and validation activities for stronger audit readiness.

Roundtable 8: Live Demo: Sustained CBP Improvement at Scale

  • See how at-home blood pressure tracking and digital coaching support members between PCP visits, while generating reporting aligned to CBP measure requirements.
  • Explore how reducing missed medication doses and identifying upward BP trends early can protect performance in triple-weighted measures like CBP.
  • Understand how sustained member engagement gives quality teams earlier visibility into rising-risk members, helping prevent mid-year performance drops.

Roundtable 9: Closing the hearing care gap with Ear Professionals Group

  • Hearing Benefits reduce costs and support whole-person health.
  • Awareness and education are critical to overcoming the 9 year delay in seeking help.
  • Comprehensive access to no member left behind.

Roundtable 10: Bingo! Smarter Risk Adjustment in 20 Minutes

  • Spot the pitfalls in your game. Use the board to call out classics like spray and pray suspecting, chart chasing Olympics, and ignoring SDoH—and why they tank risk adjustment accuracy, compliance, and trust.
  • Run a hybrid playbook. Shift to a balanced Predict–Suspect–Act approach that blends retrospective validation with prospective, in workflow prompts, enabling smart strategies and avoiding the ones you see on the board.
  • Power-plays with 360? data. Connect the dots across systems so blind spots shrink and game decisions get sharper across the board.

Roundtable 11: Exploring Operational Value in Medicare Advantage: The Role of Predictive Analytics in Earlier Detection and Care Management

  • Examine how predictive models may help identify emerging cardiac issues earlier, potentially supporting more proactive care management and improved member outcomes.
  • Discuss how undetected arrhythmias alongside other conditions may contribute to avoidable hospitalizations, quality gaps, and increased total cost of care.
  • Explore how timely data insights can help inform targeted interventions that may support HEDIS performance, Star ratings, and overall plan efficiency.

Roundtable 12: Why Interoperability Isn’t Enough: Turning Data Integrity into HEDIS and Risk Performance

  • Operating interoperability at scale is the minimum requirement to better provider relations.
  • A shared data foundation to improve value-based care performance ratings.
  • Data integrity - the missing link to better HEDIS performance.

Roundtable 13: The $100B Gap in Quality: Solving the Medication Transition Problem

  • Improve Star Ratings: Drive adherence when it’s most volatile.
  • Decrease Cost: Reduce avoidable readmissions.
  • Remove Complexity: One platform for digital outreach, clinical support, and pharmacy fulfillment.

Roundtable 14

Roundtable 15: Precision Gap Closure: Combining Digital Quality with Tech-Enabled IHAs

  • How digital quality strategies can identify care gaps earlier and prioritize the right members for intervention.
  • Why combining digital insights with tech-enabled hybrid care can improve quality performance and member engagement.
  • What an integrated, end-to-end approach to in-home care delivery looks like in practice.

Roundtable 16: From Hindsight to Foresight: Rebuilding Risk Intelligence for the Next Era of Risk Adjustment

  • Shift from code-chasing to member-centric intelligence—fusing clinical, behavioral, SDoH, and utilization data into a living profile that improves accuracy and actionability.
  • The 60% blind spot is bleeding value: if your model can’t see it, it can’t price it. Collapse silos, capture evidence at every touchpoint, and shift from retrospective clean-up to point-of-decision specificity and timeliness.
  • Turn intelligence into an unfair advantage: treat member insight as an enterprise asset—one shared data pipeline and governance across risk, quality, and care—so you cut duplication, kill chases, align incentives, and lift outcomes.

Roundtable 17: Igniting the Next Era of Quality & Risk Performance: Is your gap closure strategy ready for the future of Medicare Advantage?

  • How leading MA plans use integrated care models to move the needle on actual gap closure.
  • The critical impact of screenings, diabetes care, and Rx adherence on Star Ratings and long-term risk.
  • Strategies for expanding delivery channels and coordinating follow-ups across the entire member journey.

Roundtable 18: Using AI to Align Network Adequacy Requirements to Directory Accuracy Standards

  • The growing regulatory scrutiny on provider directory accuracy and why reliable provider data is critical for demonstrating network adequacy compliance.
  • How health plans are using AI to validate and enhance provider data accuracy, meet network adequacy requirements, and improve member access to care.
  • Emerging strategies health plans are adopting to maintain accurate provider directories and ensure ongoing alignment with network adequacy requirements.