Providence Health Plan’s 360° Approach to Risk Adjustment

October 4, 2016 AHIP Webinar Recording

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Providence Health Plan is a not-for-profit health insurance company serving 650,000 lives in the Pacific Northwest. Providence Health Plan is part of Providence Saint Joseph Health, the third largest nonprofit health system in the US, with services in Alaska, California, Montana, New Mexico, Oregon, Texas, and Washington State.

Rebecca Welling
Rebecca Welling
Director of Coding Compliance
Providence Health Plan

Join Rebecca in this recorded webinar as she explains the risk adjustment capacity challenges her plan was facing in its MA and Exchange populations and the measures she took to improve performance. 

Webinar Highlights

With the mandate to "do more with less," discover why Rebecca turned to Natural Language Processing (NLP) technology to address her risk adjustment challenges.

Over the course of one hour, Rebecca shares how her decision to equip her coding team with access to all available information via NLP – including previously unavailable clinical data – allowed for better efficiency, increased risk capture, and reduced audit risk.  Highlights include:

  • Results of a head-to-head pre- and post-technology enabled coding comparison with the identical patient population
  • Providence Health Plan's results, including:
    • +23.6% incremental revenue PMPY
    • +$650K total incremental revenue
    • +4X coder capacity increase
    • Visibility into potential compliance issues/audit risks

View the Webinar Recording

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