UPMC Health Plan’s Risk Adjustment Transformation

June 7, 2016 AHIP Webinar Recording


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Listen as Mary Beth Jenkins & Dr. Adele Towers explain the risk adjustment challenges their plan was facing in their MA and Exchange populations. Together, they discuss how applying new technology improved performance.
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Mary Beth Jenkins

Dr. Adele Towers
Mary Beth Jenkins
SVP & COO
UPMC Health Plan

Dr. Adele Towers, MPH
UPMC Enterprises

Webinar Highlights

Spend 60 minutes with UPMC as they share how their decision to equip their coding team with access to all available information via NLP - including previously unavailable clinical data - allowed for complete risk identification.

  • Why UPMC Health Plan selected Natural Language Processing (NLP) technology to address risk adjustment challenges
  • Pre- and post-technology enabled coding workflow comparisons, NLP parsing example and data ingestion process that transformed risk adjustment operations
  • UPMC Health Plan results, including:
    • Substantial increase in RAF capture
    • Visibility into potential compliance issues/audit risks
    • 4X gain in coder productivity

View the Webinar Recording

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