RISE Radio

In 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 episode focuses on what Medicare Advantage plans need to know about flex card and Special Supplemental Benefits for the Chronically Ill (SSBCI) chan...

Dawn 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 analytics into decisions that actually change outcomes.  During this hour-long episode, Carter shares practical frameworks for working with data, regulations...

In 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 discuss the implications of the 2027 Advance Notice, new OIG compliance guidance, and the industry’s shift toward encounter-based, prospective risk ad...

Join 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 raise member trust.  Our guest is Kathleen Ellmore, cofounder and managing partner of Engagys, a health care consumer engagement consulting and advisory...

In 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 factor is a true Stars redesign, and how plans can pivot from operational wins to outcome performance. We also explore the new depression screening measur...

As 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 smarter technology and deeper clinical insight. In this 38-minute episode of RISE Radio, senior leaders from Cotiviti and Edifecs share how their rece...

Medicare 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 contract-level RADV audits—a significant departure from the historical approach of randomly selecting 60 plans annually.   During this 17-minute podc...

The 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 40-minute podcast, MA policy experts Carrie Graham and Neil Patil dissect the changing political and regulatory climate surrounding MA and offer crucial i...

Welcome 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 experience, and/or social determinants of health. Special thanks to DUOS for sponsoring this episode, which features Ana Handshuh, principal of CAT5 Strategies...

Join 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 experience, and/or social determinants of health. Katie Devlin, DHSc, MS, CPHIMS, vice president of interoperability at Cotiviti, returns to RISE Radio and is...

During 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 discusses the latest news; technology, such as AI, that can assist Medicare Advantage organizations with audit preparation and project management; and...

Dawn 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 responsible for quality and revenue, Medicare member acquisition and experience, and/or social determinants of health. In this 23-minute podcast, recorde...

Welcome 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 experience, and/or social determinants of health. Our guests are Ana Handshuh, principal of CAT5 Strategies, Melissa Smith, founder and senior advisor of the N...

Errol 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 challenges faced by health care professionals responsible for quality and revenue, Medicare member acquisition and experience, and/or social determinants o...

Calum 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 responsible for quality and revenue, Medicare member acquisition and experience, and/or social determinants of health. In this 21-minute podcast, Dr. Yacoub...

Katie 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 responsible for quality and revenue, Medicare member acquisition and experience, and/or social determinants of health. In this 21-minute podcast, Devl...

Lyle 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 sharing, and best practices for capturing SDoH codes in the medical record. About Lyle Mioduszewski  Lyle Mioduszewski is vice president of population h...

Lesley Weir, senior director, customer and product success at Veradigm, and Kate Wormington director, product management, analytics at Veradigm Payer Analytics, join us for the latest episode of RISE Radio, our podcast series that focuses on issues that impact our three communities: Quality & Revenue; Medicare Member Acquisition & Experience; and Social Determinants of Health. In this 31-m...

Breanna Krebs, the director of customer success at Apixio, joins us for the latest episode of RISE Radio, our podcast series that focuses on issues that impact our three communities: Quality & Revenue; Medicare Member Acquisition & Experience; and Social Determinants of Health. In this 11-minute podcast, Krebs discusses the impact of the double sweeps occurring this July and next January r...

Dr. Jasmine Zapata joins us for the latest episode of RISE Radio, our podcast series that focuses on issues that impact our three communities: Quality & Revenue; Medicare Member Acquisition & Experience; and Social Determinants of Health. “Dr. Jaz,” a keynote speaker at the upcoming RISE Women in Health Care Leadership Summit , Dec. 14-15 at the InterContinental San Diego, will discuss fin...

Five panelists who will speak about health policy at the upcoming RISE West 2022 conference join us for the latest episode of RISE Radio, our podcast series that focuses on issues that impact our three communities: Quality & Revenue; Member Acquisition & Experience; and Social Determinants of Health. They’ll speak on the first day of RISE West 2022 , September 1, at the InterContinental Lo...

Ryan Avery, a world record holder, two-time best-selling author, Emmy award winning journalist, and world champion, joins us for the latest episode of RISE Radio, our podcast series that focuses on issues that impact our three communities: Quality & Revenue; Member Acquisition & Experience; and Social Determinants of Health. Avery will be one of the keynote speakers at RISE National 2022 ,...

Liz Haynes, director of risk adjustment and stars for government programs at Blue Cross and Blue Shield of Kansas City, and Melissa Smith, executive vice president of consulting and professional services at HealthMine, join us for the latest episode of RISE Radio, our podcast series that focuses on issues that impact our three communities: Quality & Revenue; Member Acquisition & Experience...

Angela G. Huskey, PharmD, CPE, senior vice president and chief clinical officer at Millennium Health, joins us for the latest episode of RISE Radio, our podcast series that focuses on issues that impact our three communities: Quality & Revenue; Member Acquisition & Experience; and Social Determinants of Health. During this 21-minute podcast, we talk to Dr. Huskey about her work on identify...

During this 15-minute podcast, Dr. Abdullah Albeyatti, a family physician in the UK and an advocate for digitalization in health care, talks about practicing medicine during the pandemic, audio-only visits, the challenges and opportunities of telemedicine, and how to get the most from the technology. Dr. Albeyatti is the CEO and cofounder of Medicalchain, a company that uses blockchain technology...