AZ/NM MGMA Webinars
December 11, 2024
12:00-1:00pm MST
Advancing Value-Based Care: Key HCC Coding Updates for 2025
Risk-based payer contracts are increasingly growing within the healthcare industry, driving the ongoing shift toward value-based care. As more and more provider organizations engage in Medicare Part C (Medicare Advantage) and other risk-based contracts, understanding quality and performance along with clinical workflow integration, is critical to contract success. This session will explore Risk Adjustment Factor (RAF) scores and the 2025 updates to Hierarchical Condition Category (HCC) codes, with a focus on improving patient care. Additionally, it will provide actionable insights for providers as they navigate this transformative shift in healthcare.
Key Takeaways:
- Understand how Medicare Part C risk scores will be calculated in 2025 (using the 2024 and 2020 CMS-HCC models).
- Learn why data—and the accurate capture of HCCs—are essential for proactively developing a prospective risk model.
- Identify the steps provider organizations must take to prepare for the changes, including the importance of key stakeholder alignment to attain the goals of better care, lower cost, and improved care outcomes.
Speakers: Lucy Zielinski and Sarah Hartley
January 22, 2025
12:00-1:00pm MST
Leveraging Price Transparency Data for Provider Organizations
Join us for an insightful webinar that delves into the evolving landscape of health plan price transparency. This session will provide attendees with a comprehensive understanding of how provider organizations can leverage price transparency files for guidance to help with payer negotiations for payer relations teams, benchmark fair market value compensation for improved market positioning, and develop preferred provider networks for value-based care arrangements. We will explore how healthcare price transparency data empowers provider organizations to optimize pricing strategies, improve financial performance, and navigate regulatory challenges effectively in an increasingly competitive healthcare landscape.
In addition, we will address the challenges associated with utilizing this data. Attendees will also gain a sneak peek at the future of price transparency regulations. Don't miss this opportunity to stay informed on this data and navigate the rapidly shifting transparency landscape.
Key Takeaways:
- Understand the price transparency regulations.
- Gain insights that can be obtained from price transparency files.
- Explore the challenges related to the availability of price transparency data.
Speaker: Maria Nikol, MJ
February 12, 2025
12:00-1:00pm MST
The Rise of AI in Medical Practices and Cybersecurity Considerations
Artificial Intelligence (AI) is here to stay and has the potential to transform healthcare in several ways, from enhancing diagnostic accuracy to improving workflow efficiency. While the rise of AI in medical practices is exciting, there are important cybersecurity and risk management considerations. Medical practices are responsible for protected patient information and failure to do so can result in serious consequences.
Key Takeaways:
- A sample policy and procedure to the safe utilization of AI by your workforce in the medical practice.
- Effective steps practices can take to enhance cybersecurity and risk management.
- An understanding of how AI can pose a threat and be used to mitigate threats in medical practices.
Exploring Medicare’s Chronic Disease Management Programs: Financial Opportunities and Implementation
This 3-part webinar series provides an opportunity to learn about Medicare's chronic disease management programs that have seen widespread adoption over the past couple of years. Their unique ability to provide better care at a lower cost, combined with the large financial opportunity for providers has lead to an explosion in interest. We will discuss Remote Patient Monitoring (RPM), Chronic Care Management (CCM), Remote Therapeutic Monitoring (RTM), and Principal Care Management (PCM) with a focus on RPM.
Key Takeaways:
- Understand what is driving the large scale adoption of RPM, CCM, PCM, and RTM.
- Quantify both the clinical and financial outcomes of these programs.
- Master the CPT codes and eligibility requirements, as well as how providers are combining various programs to maximize patient outcomes and financial returns.
- Identify which of the newly available medical devices work best in your patients home setting, whether that is a house, rural community, independent living, assisted living, or SNF.
- See real world examples of what continues to lead to success when implementing such programs.
Part 1 – February 26, 2025
12:00-12:30pm MST
We'll look at a combination of factors that are driving rapid adoption of these programs by payers, providers, and patients. We will dive into CPT codes, who can and cannot bill for services, and the different ways groups are implementing them.
Part 2 – March 12, 2025
12:00-12:30pm MST
Just as payer support has rapidly exploded over the past few years, so has the available technology to make it easier than ever to implement this enormous opportunity. In this section we'll dive into the medical device options available to groups implementing RPM and compare the pros and cons of different equipment. We'll look at 4G cellular blood pressure monitors, weight scales, glucose monitors, thermometers, CGMs, wearables, radar-based contactless monitoring devices, and Bluetooth.
Part 3 – March 26, 2025
12:00-12:30pm MST
In this session we’ll tie it all together with real world examples of what to keep in mind when looking to implement a successful RPM program, EHR integrations, general vs. direct supervision, at home v. facility-based programs. We'll also touch on the future of these programs and where we see it all headed.
Speaker: Alex Wheeler