Episode 35: Data is the new documentation: Preparing revenue cycle leaders for a connected health care ecosystemRevenue cycle success increasingly depends on an organization's ability to access, exchange, validate, and use data across a growing health care ecosystem. Documentation quality, coding accuracy, and compliant billing practices have supported… Oct 19 26October 19, 2026Podcast at RISE Radio
Episode 34: The health care quality shift: Always-on, digital, and connectedThe rules of health care quality are changing fast, and the biggest shift is simple to say but harder to execute. Our latest episode focuses on this fundamental shift in health care quality performance, the future of digital quality, and the… Sep 10 26September 10, 2026Podcast at RISE Radio
Episode 33: 5 trends shaping value-based care in 2026In our latest episode, we break down the biggest findings from Reveleer's "The State of Technology in Value-Based Care 2026," a report based on a survey of 200 senior payer and provider executives. During this 26-minute discussion, Reveleer President… Aug 31 26August 31, 2026Podcast at RISE Radio
Episode 32: Flex cards and SSBCI changes under the 2027 MA Final RuleIn this episode of RISE Radio, we share an excerpt from the April 29 RISE webinar featuring Ana Handshuh, principal at CAT5 Strategies, and Melissa Smith, founder of Newton Smith Group, as they walk through the 2027 Medicare Advantage Final Rule.This… May 12 26May 12, 2026Podcast at RISE Radio
Episode 31: The 5 skills every health leader needs to succeed in value-based careDawn Carter, senior director of health policy and regulatory affairs at Centauri Health Solutions, joins RISE Radio for a lively discussion on the five skills health care leaders need to succeed in value-based care, starting with how to turn… Mar 12 26March 12, 2026Podcast at RISE Radio
Episode 30: Navigating the shift to prospective risk adjustment with hybrid AIIn this 20-minute episode of RISE Radio, Editorial Director Ilene MacDonald sits down with Dr. Matt Lambert, the former chief medical officer at Reveleer, to unpack the rapidly evolving landscape of Medicare Advantage risk adjustment. Together, they… Feb 13 26February 13, 2026Podcast at RISE Radio
Episode 29: Agile Engagement: A Cost-Effective Path to Better Member BehaviorJoin RISE Radio Editorial Director Ilene MacDonald for this 15-minute episode that explores how agile engagement replaces slow, campaign-centric outreach with rapid testing, hyper-personalization, and real-time learning that lower cost of care and… Feb 05 26February 05, 2026Podcast at RISE Radio
Episode 28: Inside the 2027 MA and Part D Proposed Rule: Star ratings, equity, and what plans must do nextIn this hour-long episode of RISE Radio, Editorial Director Ilene MacDonald sits down with industry experts to break down the changes in CMS’ 2027 Medicare Advantage and Part D proposed rule, why removing 12 measures and bringing back the reward… Dec 05 25December 05, 2025Podcast at RISE Radio
Episode 27: Innovation roadmap: Cotiviti on a proactive approach to risk adjustmentAs regulatory pressures intensify and the demand for measurable ROI grows, health care organizations are rethinking how they approach risk adjustment. The landscape is shifting—from retrospective reviews to real-time, proactive strategies powered by… Nov 20 25November 20, 2025Podcast at RISE Radio
Episode 26: What to know about the new era of RADV auditsMedicare Advantage plans are about to face unprecedented scrutiny as the Centers for Medicare & Medicaid Services (CMS) implements a dramatically expanded approach to RADV audits. Starting in 2025, every Medicare Advantage plan will be subject to… Sep 09 25September 09, 2025Podcast at RISE Radio
Episode 25: The political shift: How Medicare Advantage plans can navigate coming changesThe Medicare Advantage (MA) landscape is shifting dramatically. With over half of all Medicare beneficiaries now enrolled in MA plans, the program faces unprecedented scrutiny from lawmakers, regulators, and beneficiaries themselves. During this… Aug 08 25August 08, 2025Podcast at RISE Radio
Episode 24: Post-Election Insights for Medicare AdvantageWelcome to the latest episode of RISE Radio, our podcast series that focuses on issues that impact policies, regulations, and challenges faced by health care professionals responsible for quality and revenue, Medicare member acquisition and… Nov 26 24November 26, 2024Podcast at RISE Radio
Episode 23: Staying ahead of interoperability to drive lasting impactJoin us for the latest episode of RISE Radio, our podcast series that focuses on issues that impact policies, regulations, and challenges faced by health care professionals responsible for quality and revenue, Medicare member acquisition and… Nov 08 24November 08, 2024Podcast at RISE Radio
Episode 22: Wolters Kluwer’s Melissa James offers strategies to survive a RADV audit in 2024 and beyondDuring this 20-minute podcast, Melissa James, senior consultant at Wolters Kluwer, Health Language, provides insight into RADV audits for coders, auditors, coding managers, senior leaders, chief financial officers, and chief executive officers. She… Oct 04 24October 04, 2024Podcast at RISE Radio
Episode 21: Centauri Health Solutions’ Dawn Carter offers insights into the transition of risk adjustment model V24 to V28Dawn Carter, director of product strategy at Centauri Health Solutions, joins us for the latest episode of RISE Radio, our podcast series that focuses on issues that impact policies, regulations, and challenges faced by health care professionals… May 09 24May 09, 2024Podcast at RISE Radio
Episode 20: Navigating the 2025 Medicare Advantage Final Rule: Expert Analysis and Strategic InsightsWelcome to the latest episode of RISE Radio, our podcast series that focuses on issues that impact policies, regulations, and challenges faced by health care professionals responsible for quality and revenue, Medicare member acquisition and… Apr 23 24April 23, 2024Podcast at RISE Radio
Episode 19: Healthfirst’s Errol Pierre on the end of continuous enrollment, restart of Medicaid redeterminations, and lessons learnedErrol Pierre, senior vice president of state programs at Healthfirst, the largest nonprofit health plan in New York, joins us for the latest episode of RISE Radio, our podcast series that focuses on issues that impact policies, regulations, and… Jan 08 24January 08, 2024Podcast at RISE Radio
Episode 18: IQVIA’s Dr. Calum Yacoubian on empowering payers in risk, quality, and health equity with clinical NLPCalum Yacoubian, M.D., director of NLP health care strategy at IQVIA, joins us for the latest episode of RISE Radio, our podcast series that focuses on issues that impact policies, regulations, and challenges faced by health care professionals… Oct 24 23October 24, 2023Podcast at RISE Radio
Episode 17: Cotiviti’s Katie Devlin on navigating the health care interoperability landscapeKatie Devlin, DHSc, MS, CPHIMS, vice president, interoperability, Cotiviti, joins us for the latest episode of RISE Radio, our podcast series that focuses on issues that impact policies, regulations, and challenges faced by health care professionals… Sep 05 23September 05, 2023Podcast at RISE Radio
Episode 16: Ciox Health’s Lyle Mioduszewski on SDoH, Z codes, and use of member data to close gaps, reduce costs, and optimize utilizationLyle Mioduszewski, vice president of population health and payer growth for Ciox Health, is our guest for the latest episode of RISE Radio.In this 26-minute podcast, Mioduszewski discusses social determinants of health (SDoH), data collection and… Jul 05 23July 05, 2023Podcast at RISE Radio
