Creating Your Marketplace 2.0
Success Blueprint

July 27th 2016 / 1:00 PM EST.

How ready is your organization to manage Marketplace 2.0 changes, maintain Marketplace revenue integrity and increase your market footprint? If there is any doubt, then you should join Edifecs on July 27th for a complimentary webinar entitled, “Creating Your Marketplace 2.0 Success Blueprint.”

By now, the 2016 CMS Risk Adjustment and Reinsurance report has been published and we are all painfully aware of the “winner” and “losers” (those health plans who paid into the program and those who received payments). And with that, two of the 3Rs (risk corridors and reinsurance) have run their course, leaving risk adjustment as the only risk stabilizing mechanism operating in 2017 and beyond.

However, that’s not the only challenge facing payers in the coming years. Operational excellence (which feeds business success) across areas such as data quality/management, audit preparation (IVA/RADV), and Cost Sharing Reduction (CSR) management will be mission critical to ensure revenue integrity and increase market share. Wrap all these aspects together and you’ve got the quagmire that is “Marketplace 2.0.”

In this webinar, attendees will learn:

    • What are the challenges with Marketplace 2.0 that can impact revenue?
    • What solution/approach must be in place to manage your Edge Server reporting moving forward
    • How to ensure data quality to streamline IVAs (and be better prepared for RADV audits)
    • How to accurately calculate, reconcile, forecast CSR payments

Who should attend? Health plan leaders involved in the following areas:

    1. Commercial
    2. Individual
    3. ACA / Reform
    4. Finance
    5. Operations
    6. Compliance
    7. Government Programs
    8. Actuarial
    9. Risk Adjustment
    10. Encounter Management
    11. Strategy
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    Meet the Presenters
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Hitesh Kurani, Practice Lead, Solution Consulting, Edifecs

Hitesh Kurani is a Practice Lead of Solution Consulting at Edifecs. His career in healthcare spans 12+ years, which most recently includes advising solutions to health plans that will support their revenue integrity and growth, with a focus on encounter management and risk adjustment solutions for Medicare Advantage, Medicaid and Commercial health plans. Prior to that, his experience spans from providing consulting in healthcare business support services, building solutions to support health plan operations, and managing the implementations of enterprise software.
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Aaron Fulner, Sr. Director, Product Marketing, Edifecs

Aaron Fulner is a Senior Director of Product Marketing at Edifecs. A passionate, seasoned product marketing leader, Aaron has spent many years directing the go-to-market strategies behind cutting edge, enterprise-level software solutions for health insurers. His focus spans insurers involved in commercial, managed Medicaid, Medicare Advantage and Dual Eligible programs. His expertise also spans insurers of all sizes and types ranging from small, regional plans, large, national plans and Blue Cross/Blue Shield organizations.