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Month
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November 11.02.17
Cognisight has been intimately involved in the development of the Initial Validation Audit program since the onset of planning with CMS. After two years of providing best-in-class audit services to several health plans across the country as an IVA entity, Cognisight—in partnership with CDPHP—will share our expertise and the many lessons learned during the pilot years in an upcoming, complimentary webinar. In less than one hour, you’ll also gain a thorough understanding of how Cognisight can help with your health plan’s Benefit Year 2017 audit and why you should choose us—the best in class IVA partner. Register now to join us on Tuesday, November 14th at 3:30 PM EST for Collaborating for a Successful Commercial RADV, space is limited!
October 10.09.17
We’re proud to be a premier sponsor and presenter at the The Risk Adjustment Integration & Compliance Forum in Las Vegas. Please join Cognisight’s Vice President of Operations, Christine D'Amico, on Thursday, November 16th at 3:15 pm as she co-presents a case study on “Our Commercial RADV Audit Experience” with UCare’s Risk Adjustment Compliance Coding Manager, Jenni Monfils. Hope to see you there!
10.03.17
Cognisight’s Executive Vice President, Kim Browning, recently co-authored an article with Jacobson’s Senior Vice President and Health Sales Manager, Abbe Sodikoff. In the article, MBI Ready to Replace HICN: Is Your Organization Ready?, Kim and Abbe discuss how the Medicare system is set to undergo a drastic change as all Medicare beneficiaries will be transitioning to a new identification system that is designed to prevent medical identity theft, better protect private healthcare and financial information, and safeguard federal healthcare benefits and service payments. Expected to impact claims, reporting and payments for millions of individuals, this conversion will require significant changes to current healthcare systems. Is your organization prepared? Click here to find out!
September
09.27.17 In case you missed it, slides from our recent Removing Risk in Risk Adjustments webinar have been posted to our website’s Resources page. Download them now to gain a thorough understanding of today’s regulatory climate and how Medicare Advantage plans are at risk for overcoding penalties if they’re not simultaneously looking for newly found and previously submitted HCCs. You’ll also learn how to help remove the risk in your risk adjustment strategy with a bidirectional approach that positively positions your health plan to comply with CMS’ expectations and regulatory audits. 

09.18.17

We’re proud to be a sponsor and presenter at National PACE Association’s 2017 Annual Conference in Boston. Please join Cognisight’s Executive Vice President, Kim Browning, as she co-presents Removing Risk from Your Risk Adjustments with Trinity Health PACE’s Vice President of Clinical Operations and Chief Nursing, Compliance & Privacy Officer, Carrie Hays McElroy, on October 17th at 3:30 pm. Hope to see you there!

09.14.17

As a wholly owned subsidiary of the Greater Rochester Regional Independent Practice Association (GRIPA) , Cognisight would like to congratulate the Clinical Pharmacist Team on their recently published article in the September issue of American Journal of Health-System Pharmacy (AJHP). Population Health Management: An Independent Physician Organization Approach describes the role of clinical pharmacists and their impact on population health and value-based contracts within a multidisciplinary care management team. The article also discusses their goal to help physicians manage the care of their most costly and complex patients. Click here to read the article now. 
09.13.17
Please join us on Wednesday, September 27th at 3:30pm EST to gain a thorough understanding of today’s regulatory climate and how your Medicare Advantage health plan is at risk for overcoding penalties if you’re not simultaneously looking for newly found and previously submitted HCCs during our complimentary, live webinar. You’ll also learn how to help remove the risk in your risk adjustment strategy with a bidirectional approach that positively positions your health plan to comply with CMS’ expectations and regulatory audits. Register now for Cognisight’s Removing the Risk in Risk Adjustments webinar, space is limited!
May 05.25.17
Cognisight’s Executive Vice President, Kim Browning, co-presented with UCare’s Risk Adjustment Compliance Coding Manager, Jenni Monfils, and CDPHP’s Risk Adjustment Manager, Tom Nasadoski, at RISE’s 10th Annual Risk Adjustment Forum in San Diego. In case you missed it, slides from “Initial Validation Audit Pilot: Lessons Learned, Results & Industry Reactions” can be downloaded from here.
05.22.17 Congratulations to Cognisight/GRIPA Chief Financial Officer, Bill Pelino, who was selected for Rochester Business Journal’s 2017 Financial Executive of the Year Award! The award recognizes financial executives who have made outstanding contributions to their organizations and to the Greater Rochester community throughout the past year. It’s always rewarding when a team member can be recognized for their tireless efforts on behalf of Cognisight and GRIPA. Way to go, Bill!
05.10.17
Cognisight’s Executive Vice President, Kim Browning, was recently interviewed by Modern Healthcare regarding CMS’ decision last week to make the HHS-Operated Commercial RADV Benefit Year 2016 Initial Validation Audit a second pilot year. In the article, Trump Administration Backs Off Penalizing Exchange Plans for Not Auditing Risk Adjustment Programs, Kim discusses some of the challenges Issuers faced during the first pilot year and how CMS is working to remediate those issues moving forward.
05.04.17 It’s our pleasure to announce that an article authored by Cognisight’s Executive Vice President, Kim Browning, has been included in the May 2017 edition of hfm magazine, published by the Healthcare Financial Management Association (HFMA). Kim’s article, “The Risky Business of Risk Adjustment Data Validations,” leverages insight recently gleaned from discussions with health plan leaders to explore conjecture and fact-based evidence as to why plans are chosen for a CMS RADV audit, how healthcare organizations can better prepare for their own selection, and anticipated CMS changes to the RADV audit process. The full article can be read here.
05.03.17 Cognisight participated in REGTAP’s ACA HHS-Operated RADV Webinar Series this afternoon where updates on the Benefit Year 2016 Initial Validation Audit (IVA) were shared. In an effort to continue our long-standing goal of sharing knowledge with clients and potential clients, Cognisight has prepared a summary of the items affecting IVAs in our latest Client Brief.
05.01.17
We’re proud to be a premier sponsor and presenter at the 10th Annual Risk Adjustment Forum in San Diego. Please join Cognisight’s Executive Vice President, Kim Browning, on Tuesday, May 23rd at 9:45 am as she co-presents “IVA Pilot Results: Lessons Learned, Results & Industry Reactions” with CDPHP’s Risk Adjustment Manager, Tom Nasadoski, and UCare’s Risk Adjustment Compliance Coding Manager, Jenni Monfils. Hope to see you there!
April 04.07.17 The pilot year for the Initial Validation Audit (IVA) has concluded and the real show is about to begin. IVA Entity Contenders vs. Pretenders: A Post-Pilot Year Update, written by Cognisight’s Executive Vice President, Kim Browning, was recently published in Healthcare Reform Magazine. In the article she discusses tips on what to look for and what to avoid when selecting your IVA vendor by CMS’ upcoming April 14-28, 2017 designation deadline.
04.06.17 Yesterday, REGTAP conducted a session for IVA entities to share feedback related to the HHS-Operated RADV audit as they prepare Benefit Year 2016 Protocols. In an effort to continue our long-standing goal of sharing knowledge with clients and potential clients, Cognisight has prepared a summary of the items affecting Initial Validation Audits in our latest Client Brief
04.04.17
Yesterday, CMS released the “Final Notice of Methodological Changes for Calendar Year 2018 for
Medicare Advantage Capitation Rates, Part C and Part D Payment Policies, and 2018 Advanced Call Letter.” In an effort to continue our long-standing goal of sharing knowledge with clients and potential clients, Cognisight has prepared summaries of the salient items affecting risk adjustments for Medicare Advantage plans and PACE programs in our latest Client Briefs.
March 03.08.17
Yesterday, CMS shared late breaking IVA news at the 11th Annual RISE Nashville Summit. In an effort to continue our long-standing goal of sharing knowledge with clients and potential clients, Cognisight has prepared a summary of the items affecting IVAs in our latest Client Brief.
February 02.16.17 On February 15th, REGTAP shared updates for the upcoming Initial Validation Audit during its’ ACA HHS-Operated RADV Webinar Series. CMS also hosted a HHS-RADV IVA Entity and Coder meeting yesterday where IVA entities had the opportunity to provide pilot year feedback. In an effort to continue our long-standing goal of sharing knowledge with clients and potential clients, Cognisight has prepared a summary of the items affecting IVAs, along with the key discussion topics from the meeting, in our latest Client Brief
02.15.17 Cognisight is proud to be a premier sponsor and exhibitor at the 11th Annual RISE Nashville Summit. Executive Vice President Kim Browning will also be moderating the educational session, “Lessons Learned from 4 and 5 Star Plans” on March 6th. Join us and save 15% as our guest with discount code “HSM282” at https://goo.gl/Wzaays. Hope to see you there!
02.07.17 Are you an IT professional looking to join a thriving business and industry leader? If so, we’ve got the opportunity for you! Cognisight is seeking a Manager of Information Technology Operations to join our growing team. If you or someone you know might be interested, check out our website’s Careers page for more info.  
02.06.17 The Initial Validation Audit (IVA) pilot has just concluded—now it’s time to get ready for this year! So if you're an Issuer who will be participating in the audit for the first time—or weren’t happy with your 2015 pilot year experience—you won't want to miss Cognisight's IVA Pilot Highlights & 2016 Audit Year Insights webinar. In less than one hour, you'll get practical advice and specific action steps you can take to better prepare for the upcoming 2016 dates of service audit and learn about key factors critical for success. Join Kim Browning, Cognisight's Executive Vice President and pilot year Senior Official, during one of our two conveniently scheduled sessions on February 16th or February 20th. Space is limited, register now! 
02.03.17
Yesterday, CMS released the Advance Notice of Methodological Changes for CY 2018 for Medicare Advantage Capitation Rates, Part C and Part D Payment Policies. In an effort to continue our long-standing goal of sharing knowledge with clients and potential clients, Cognisight has prepared summaries of the proposed items affecting risk adjustments for Medicare Advantage plans and PACE programs in our latest Client Brief.
January 01.26.17 Cognisight’s Senior Official, Kim Browning, and Chief Information Officer, Jamie Hayslip, participated in yesterday’s HHS-RADV Lessons Learned IVA Entity meeting. In an effort to continue our long-standing goal of sharing knowledge with clients and potential clients, we have summarized the topics that were discussed, a few expectations, and next steps in our latest Client Brief.   
01.05.17
On December 23rd, CMS released a RFI to develop PACE pilots for new populations. Through the RFI—due on February 10, 2017—CMS is soliciting information on the design and future implementation of a broad range of PACE pilots. These pilots include, but are not limited to, helping those with physical mobility limitations, intellectual and developmental disabilities, and complex medical and functional support needs and are at risk of needing nursing home level of care. A member of the National PACE Association (NPA), Cognisight has been a long-time supporter of PACE and provides risk adjustment services to programs that make up more than 40% of all participants in the 55+ population. Cognisight, along with the NPA, appreciates the progress CMS has made towards implementing pilots for new PACE populations. Click here for more information. 
December 12.19.16
On December 16th, CMS announced final regulations for the Patient Protection and Affordable Care Act in HHS’ Notice of Benefit and Payment Parameters for 2018. In an effort to continue our long-standing goal of sharing knowledge with clients and potential clients, Cognisight has prepared a summary of the proposed changes affecting risk adjustments in our latest Client Brief.
November 11.17.16
Cognisight’s Executive Vice President, Kim Browning, co-presented with Health Choice’s Director of Medicare Advantage & Commercial Risk Adjustment, Jamee Hubler, at RISE’s Risk Adjustment Forum & RADV Master Class in Miami last week. In case you missed it, download the slides from Strategies for Building Effective RADV Preparation & Response Teams.
October 10.31.16 In case you missed it, Cognisight’s Executive Vice President, Kim Browning, co-presented with LIFE St. Mary’s Director of Finance, Jennifer White, at National PACE Association’s 2016 Annual Conference in San Francisco last week. Slides from their presentation, “Internal Validation Audits: Benefits, Implementation & Taking Action,” can be downloaded here.
10.19.16 Cognisight’s Executive Vice President, Kim Browning, co-presented with UCare’s Risk Adjustment Compliance Coding Manager, Jenni Monfils, at the 5th Annual Health Insurance Exchange Summit in San Antonio. In case you missed it, slides from “IVA Process Update—What Do We Know So Far?” can be downloaded here.
10.12.16 Cognisight's proud to be a premier sponsor and presenter at The Risk Adjustment Forum & RADV Master Class in Miami. Please join Cognisight’s Executive Vice President, Kim Browning, on Thursday, November 10th at 11:15 am as she co-presents “Strategies for Building Effective RADV Preparation & Response Teams?” with Health Choice’s Director of Medicare Advantage & Commercial Risk Adjustment, Jamee Hubler. Hope to see you there!
10.11.16
Please join Cognisight in celebrating care managers during National Case Management Week October 9-15th. National Case Management Week helps educate payers, providers, regulators, and consumers about the tremendous value case managers bring to the successful delivery of health care. At Cognisight, we are especially proud of the work our GRIPA Care Managers do to support their patients and providers in improving quality (not just metrics, but life of patients too) while working to decrease costs.
September
09.23.16
We’re proud to be a sponsor and presenter at National PACE Association’s 2016 Annual Conference in San Francisco. Please join Cognisight’s Executive Vice President, Kim Browning, as she co-presents Internal Validation Audits: Benefits, Implementation & Taking Action with LIFE St. Mary’s Director of Finance, Jennifer White, on October 24th at 10:00 am. Hope to see you there!
09.20.16
We’re proud to be a premier sponsor and presenter at the 5th Annual Health Insurance Exchange Summit in San Antonio. Please join Cognisight’s Executive Vice President, Kim Browning, on Monday, October 17th at 10:45 am as she co-presents “IVA Updates—What Do We Know So Far About the Process?” with UCare’s Risk Adjustment Compliance Coding Manager, Jenni Monfils. Hope to see you there!
August 08.30.16 On August 29th, CMS proposed new regulations for the Patient Protection and Affordable Care Act in HHS’ Notice of Benefit and Payment Parameters for 2018. In an effort to continue our long-standing goal of sharing knowledge with clients and potential clients, Cognisight has prepared a summary of the proposed changes affecting risk adjustments in our latest Client Brief
08.09.16
In case you missed it, a podcast from our recent The Risky Business of Claims-Only Risk Adjustments webinar has been posted to our website. Download it now to learn why it's crucial for health plans to not only audit their retrospective chart reviews and prospective assessments but their claims too!
July 07.12.16
With over 95% of Medicare Advantage risk adjustments coming from claims, why don’t health plans routinely audit them? Without doing so comes inherent RADV risk. Join us on Thursday, July 28th at 3:30pm EST to learn why it’s crucial for health plans to not only audit their retrospective chart reviews and prospective assessments but their claims too—and gain a thorough understanding of the ramifications for failing to do so—during our free, live webinar. Register now for The Risky Business of Claims-Only Risk Adjustments to get practical advice and specific action steps you can take to easily incorporate claims-only audits into your risk adjustment program and minimize RADV risk. Space is limited. 
June 06.29.16 Cognisight’s Chief Medical Officer, Mark H. Belfer, DO, FAAFP, and Chief Information Officer, Jamie Hayslip, recently co-authored an article in the May/June 2016 issue of The Bulletin for Healthcare & Technology—The Journal of the Monroe County Medical Society. Their article highlights the technological breakthroughs in medicine over the past half-century and predicts what the future of outpatient care holds. Read The Evolution and Impact of Technology on the Practice of Medicine: The Movement From Reactive to Predictive Health Care in its’ entirety now.
06.28.16 Chief Medical Officer at Cognisight, Mark H. Belfer, DO, FAAFP, was recently interviewed for an article in the Democrat & Chronicle. In the article, Dr. Belfer talks about why men are less likely to go to the doctor and the five health-related conditions they need to be aware of. Read Top 5 Health Issues Men Need to Know now.
06.08.16
Congratulations to Cognisight’s Clinical Reviewer—Gail Woytek, RHIA, CCS, CRC—who was selected by NYHIMAs Rochester chapter for the House of Delegates at this week’s 2016 Annual Conference in Long Island. Key topics at the conference included data analytics, electronic health records, value-based payments, ICD-10, information governance, and regulatory issues. The House of Delegates convened there to review and improve NYHIMAs strategic plan and vote on any by-law changes. For more information on this year’s conference, please click here.
 May 05.26.16 In case you missed it, slides from Kim Browning’s Risk Adjustment Forum presentation, “Deconstructing the RADV: The Past, Present & Future of RADV,” in Austin, Texas this week can be downloaded from our Resources webpage!
05.03.16
Cognisight held webinars last week to help clients gain a better understanding of CMS' new Initial Validation Audit requirements and the implications affecting them (for 2015 dates of service). The webinar highlighted information presented during the April 13, 2016 REGTAP HHS-Operated RADV Training Series and included Issuer Documentation, Screen Shots, Three-Part Audit—Health Status, Demographic Enrollment & NEW Claims Validation Audit, and IVA Work Papers.  In case you missed it, a podcast can be downloaded here.
April 04.26.16 We’re proud to be a premier sponsor and presenter at The Risk Adjustment Forum May 24-25th in Cedar Creek, Texas. Please join Cognisight’s Executive Vice President, Kim Browning, on Tuesday, May 24th at 2:00 pm as she presents “Deconstructing the RADV Audit: the Past, Present, and Future of RADV.” Hope to see you there!
04.19.16
Are you a sales professional looking to join a thriving business and industry leader? We’ve got the opportunity for you! Cognisight is seeking a Vice President of Business Development to join our growing team. If you or someone you know might be interested, check out our website’s Careers page for more info.
04.18.16 Cognisight participated in REGTAP’s “Health Insurance Marketplace Program Training Series” last Wednesday, April 13th where new requirements and implications for the ACA HHS-Operated RADV were presented. In an effort to continue our long-standing goal of sharing knowledge with clients and potential clients, Cognisight has provided a summary of the items affecting Initial Validation Audits in our latest Client Brief.
04.05.16 CMS released the Final Notice of Methodological Changes for CY 2017 for Medicare Advantage Capitation Rates, Part C and Part D Payment Policies on April 4, 2016. In an effort to continue our long-standing goal of sharing knowledge with clients and potential clients, Cognisight has prepared summaries of the salient items affecting risk adjustments for Medicare Advantage and PACE programs in our latest Client Briefs.
04.04.16 Executive Vice President, Kim Browning, recently attended a Medicare Advantage health plan focus group at the 2016 RISE Nashville Summit led by Morepace. In an effort to share knowledge with clients and potential clients, Cognisight has prepared a session summary review. Highlights include feedback on closing and enrolling, getting care, filling prescriptions, and health plan and provider communications. Please click here to download it now. 
04.03.16 Join Cognisight and the American Health Information Management Association (AHIMA) in celebrating health information professionals during the 27th Annual Health Information Professionals Week April 3-9th. It’s a showcase of the 1000’s of health information management professionals who perform their duties masterfully throughout the year. It’s an allied health profession that’s responsible for ensuring the availability, accuracy, and protection of the clinical information needed to provide healthcare-related decisions. We are proud to support AHIMA―whose theme this year―“Accurate Information, Quality Care,” reiterates its belief in the necessity of building quality healthcare through quality information.
04.01.16
Cognisight attended CMS’ HHS-Operated Risk Adjustment Methodology meeting yesterday in Baltimore, Maryland. In an effort to continue our long-standing goal of sharing knowledge with clients and potential clients, items germane to Cognisight services have been summarized in our latest Client Brief.
March 03.17.16 Please join Chief Medical Officer Mark H. Belfer, DO, FAAFP at the ACO & Payer Leadership Summit in Dallas, Texas where he’ll present “Physician Leadership in a Value-Based World: Actionable Reporting to Drive Behavior Change.” Hope to see you there!
03.07.16 In case you missed it, a podcast from our recent Cognisight 101 | Commercial RADV IVA Service webinar has been posted on our website. Download it now to learn how we can help with your audit and why you should choose Cognisight, the best in class Initial Validation Audit partner!
03.02.16 On April 1st, Cognisight's Chief Medical Officer, Mark H. Belfer, DO, FAAFP, will be presenting "Patient Engagement and Care Management: A Successful Model" at the NYSOMS Regional Osteopathic Convention in Hauppauge, New York. For more event info, please click here.
03.01.16
Final regulations for the Patient Protection and Affordable Care Act were announced on February 29, 2016 in HHS’ Notice of Benefit and Payment Parameters for 2017. In an effort to continue our long-standing goal of sharing knowledge with clients and potential clients, Cognisight has prepared a summary of the final changes affecting risk adjustments in our latest Client Brief.
February
02.22.16 On 2/19, CMS released the Advance Notice of Methodological Changes for CY 2017 for Medicare Advantage Capitation Rates, Part C and Part D Payment Policies. In an effort to continue our long-standing goal of sharing knowledge with clients and potential clients, Cognisight has prepared summaries of the proposed items affecting risk adjustments for Medicare Advantage and PACE plans in our latest Client Brief.
02.22.16 Cognisight is proud to be a premier sponsor and exhibitor at the 10th Annual RISE Nashville Summit. Executive Vice President Kim Browning will also be moderating the educational session, “Early Insights Into Medicaid Expansion: What We’ve Learned To-Date” on March 22nd. If you plan to attend, stop by our booth to learn how Cognisight can help with your risk adjustment efforts and for your chance to win an Apple Watch. Hope to see you there!
02.18.16 Cognisight participated in REGTAP’s “Health Insurance Marketplace Program Training Series” yesterday where updates on the ACA HHS-Operated RADV were discussed. In an effort to continue our long-standing goal of sharing knowledge with clients and potential clients, Cognisight has highlighted the items affecting Initial Validation Audits—including exemptions in 2016, sample selection, and timeline updates—in our latest Client Brief
January 01.29.16 Are you a sales professional looking to join a thriving business and industry leader? We’ve got the opportunity for you! Cognisight has immediate openings for a Vice President of Business Development and Sales Support Specialist/Proposal Writer to join our growing team. If you or someone you know might be interested, check out the Careers page for more info.
01.28.16  On January 27th, CMS released a statement informing Medicare Advantage plans and PACE programs that the February 1, 2016 submission deadline has been extended. Due to an issue stemming from the implementation of diagnosis cluster 410 error code changes at the beginning of the year, CMS has granted a three week extension period. Plans now have until February 22, 2016 to submit 2014 dates of service. In an effort to continue Cognisight’s long-standing goal of sharing knowledge with clients and potential clients, we are pleased to provide you with this information. To read the official statement in its entirety, please click here
01.26.16
The 2016 Commercial RADV IVA vendor selection deadline is fast approaching—NOW is the time to select your Initial Validation Audit vendor! In less than 30 minutes, gain a thorough understanding of how Cognisight can help with your health plan’s audit and why you should choose us—the best in class IVA partner. Join us on Thursday, February 18th at 3:30pm EST/12:30pm PST for a free, live webinar. Learn how our IVA service can fulfill your CMS/HHS 2016 RADV IVA requirement—with unparalleled quality—in a quick and commitment-free way. Register now, space is limited.
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