Health plan and clinical leaders on why retrospective chart chase is failing — and what organizations are doing instead.
Webinar Overview
CMS is auditing six years of Medicare Advantage payments in the next 13 months. Extrapolation risk is real. And the retrospective workflows many organizations built risk adjustment programs around are no longer sustainable under today’s level of regulatory and financial scrutiny.
In this Becker’s Healthcare webinar, leaders from Community Health Choice, Community Health Plan of Washington, Clear Spring Healthcare, and InterSystems discuss:
- where today’s model breaks down,
- why incremental process improvements are no longer enough,
- and how plans are moving toward more proactive, clinical-first approaches.
The discussion explores the operational, financial, provider, and clinical implications of continuing to rely primarily on retrospective chart chase.
Speakers:
- John Murtha, Health Plan Executive, InterSystems
- Lisa Parnell, Director of Risk Adjustment, Community Health Choice
- Mark Dabney, Director of Risk Adjustment, Community Health Plan of Washington
- Dr. John Mazzutti, Chief Medical Officer, Clear Spring Healthcare
Moderated by Lucas Vos, Becker’s Healthcare
What’s Covered in This Session
Key discussion topics include:
- The operational and financial risks of retrospective-only workflows
- Why CMS audit activity and extrapolation are changing the economics of risk adjustment
- How provider abrasion impacts long-term collaboration and documentation quality
- What a “clinical-first” model looks like operationally
- How CCDs, ADT feeds, and EHR integrations support earlier intervention
- Why provider education and workflow alignment matter more than ever
- How leading organizations are positioning themselves ahead of the next audit cycle
Navigate the Conversation
Jump directly to the topics most relevant to your organization:
- [0:00] Welcome and introductions
- [3:10] Why retrospective chart chase is becoming unsustainable
- [8:07] Where today’s model breaks down most visibly
- [12:25] Why incremental workflow improvements are no longer enough
- [20:29] What a clinical-first approach looks like in practice
- [30:12] Using CCDs, ADT feeds, and real-time data at the point of care
- [36:35] RADV exposure, extrapolation, and enterprise financial risk
- [45:10] What leading plans are doing differently right now
Read the Webinar Summary:
Key insights, notable quotes, and recommended action items from the discussion.
Talk to an InterSystems Expert
Learn how InterSystems helps health plans move from retrospective retrieval toward encounter-aligned workflow.