RISE Radio
Join the RISE team as we chat with industry leaders and explore ever-changing 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. Produced by RISE, the number one source for information on all things Medicare Advantage.
RISE Radio
Episode 15: Veradigm’s Lesley Weir and Kate Wormington on risk adjustment and quality changes in the 2024 MA and Part D Rate Announcement and 2024 MA Final Rule
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-minute podcast, they discuss the risk adjustment and quality changes in the final rules and their recommendations and strategies for organizations going forward.
About Lesley Weir
Lesley Weir, senior director of customer and product success at Veradigm, has over 30 years’ experience in the Medicare Managed Care industry, with specific expertise in operations, risk adjustment, and quality improvement. She has a demonstrated track record of assisting health plans in meeting operational and revenue goals, as well as developing innovative strategies to improve member’s health and experience. Prior to her role at Veradigm, she held various leadership positions at multiple provider-owned Medicare Managed Care Health Plans and a large national plan. She also spent six years working in the vendor space supporting Medicare Advantage plans across the country with their risk adjustment and quality programs.
About Kate Wormington
Kate Wormington, director, product management, joined Veradigm in January of 2023 leading theQuality Analytics solutions. For the past 20 years, Kate has focused on HEDIS® and quality reporting for both payers and providers. Kate spent close to 10 years managing complex operations of a quality analytics program supporting HEDIS, CMS Star, IHA AMP, QARR, QRS, and Medicaid State measurement sets for innovative health care organizations. She has deep experience leading a multi-state Client Success Support and Implementation team, supporting 27 clients across three products. Additionally, Kate has led an NCQA Data Aggregator Validation (DAV) project team through Cohort 2, and was in the middle of Cohort 4, providing targeted HEDIS standard supplemental data using C-CDA files. She began as a software engineer specializing in software quality, with a Masters degree in IT. She embraced the business side, utilizing product, project and client management skills. Wormington lives in Denver, Colo., originally from the UK, starting her career in health care working for the National Health Service.
About Veradigm
Veradigm Payer Analytics (formerly Pulse8) is health care analytics and technology solution delivering complete visibility into the efficacy of your Risk Adjustment, Quality, and Pharmacy Benefit Management programs. Veradigm empowers health plans and providers to eliminate waste and achieve the greatest financial impact in the Medicare Advantage, Medicaid, and ACA Commercial markets as well as with Value-Based Payment models for Medicare. Advanced analytic methodologies and flexible business intelligence tools offer real-time visibility into member behavior and provider performance while also improving efficiency for payers and at-risk providers through high-speed clinical data exchange. Veradigm's patented Dynamic Intervention Planning offers a suite of uniquely pragmatic solutions that identify the most cost-effective and appropriate interventions for closing gaps in documentation, coding, and quality. For more company information or to schedule a demo, please email payersolutions@veradigm.com