The transition to downside risk requires a deep understanding of the risk, quality, and care gaps inherent in the covered population(s). To prosper in this data-laden era of care, providers need to manage their patient populations holistically rather than through a collection of individual episodes, and be able to accurately identify, document, and report risk scores. Given the stakes, is your provider organization adequately set up to take on and succeed in managing risk? In this webinar, learn how UPMC employed a technology-enabled risk capture strategy to help providers succeed in risk-based payment models without further contributing to burnout.
Learning Objectives
- Learn how risk is calculated across varying populations and see how properly adjusting for risk can affect payments
- Understand how Natural Language Processing technology can be used to interpret unstructured clinical data like physician notes from the EMR and why that is critical to accurately identifying population risk
- Discover how UPMC leveraged technology to help the care team drive gap closure and deliver value without disrupting their existing patient-centered workflow.
- Uncover the lessons learned, outcomes attained, and roadmap utilized for implementing a successful risk capture program in risk-based payment models across several populations
Speakers
Adele L. Towers, MD MPH FACP
Dr. Towers is the Director of Risk Adjustment for UPMC Enterprises, a practicing physician, and a professor of medicine. She is directly involved in the development of healthcare related technology, with emphasis on use of Natural Language Processing (NLP) for Risk Adjustment coding and use of Clinical Analytics to optimize clinical performance. Prior to this role, she has served as the Medical Director for Health Information Management at UPMC with responsibility for CDI and inpatient coding denials.
Dr. Towers has been on the faculty in the Division of Geriatric Medicine at the University of Pittsburgh for over 25 years, and continues to see patients at the Benedum Geriatric Center in UPMC. She is the former Medical Staff President at UPMC Presbyterian, and her prior positions have been as Vice Chair for Quality Improvement and Patient Safety for the Department of Medicine, Medical Director of the Benedum Geriatric Center and Medical Director of Primary Care at the Western Psychiatric Institute and Clinic. Dr. Towers has presented the experience at UPMC with use of NLP for coding at multiple regional and national conferences.
