Capstone Performance Systems, a leader in providing expert Medicare risk adjustment consulting and services, now offers health plan management and PACE technical consulting (TAC) services. Read on for more information about these services and other news!
Risk Adjustment Advisor: July 2018

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Richard Schamp, MD Chief Executive Officer
Capstone Announces Leadership Change 
After more than 30 years in the field of geriatric care, including more than 15 years in PACE (Programs of All-inclusive Care for the Elderly) as both a medical director and risk adjustment consultant/CEO,  Capstone Performance Systems  founding CEO  Richard Schamp, MD, has passed the reigns of the company to his highly-qualified colleague, Kim Browning, CHC, PMP. Following a short break, Dr. Schamp will provide broader leadership support through Tabula Rasa HealthCare (TRHC), Capstone's parent company. 

Kim Browning  joined TRHC in May as Executive Vice President with responsibility for Capstone, including Peak Health Plan Management Services. For more information on Ms. Browning, see the next article.

Kim Browning, CHC, PMP
Kim Browning Assumes Leadership Role with Capstone Performance Systems

Kim Browning, CHC, PMP, has assumed leadership of Capstone Performance Systems. Ms. Browning joined Tabula Rasa HealthCare (TRHC), Capstone's parent company, in May as Executive Vice President responsible for Capstone, including Peak Health Plan Management Services.  

Peak PACE Solutions is now part of Capstone!

On May 1, Capstone Performance Systems, a subsidiary of Tabula Rasa HealthCare (TRHC), acquired Peak PACE Solutions from Altitude Edge (AE), following the news that AE founders' David Reyes and Ronda Hackbart would retire. Peak PACE Solutions is now Peak Health Plan Management Services and will operate as a service of Capstone.

Indira Kanouka, MD
Capstone Welcomes 
Indira Kanouka, MD, to  Consulting Team

Indira Kanouka, MD, has joined Capstone Performance Systems'  consulting team. A private practice physician, Dr. Kanouka had previously served as medical director of Beacon of Life, a PACE (Program of All-inclusive Care for the Elderly) organization, and of Specialty Hospital of Central Jersey. 

Dorothy Ginsberg, RN
PACE Consultants Dorothy Ginsberg and Mandy Hurley Join Capstone Performance Systems 

Dorothy Ginsberg, RN, a senior PACE consultant, and Mandy Hurley, a marketing and enrollment consultant, have joined Capstone Performance Systems' consulting division. Before joining Capstone, both Ginsberg and Hurley were with Altitude Edge Consultants, a national PACE consulting firm. 

"We are pleased to welcome Dorothy and Mandy to the Capstone Team," said
Mandy Hurley
Richard Schamp, MD, former CEO of Capstone. "Their expertise in the PACE exploration and start-up phases, as well as in ongoing operations, will allow Capstone to broaden its offerings to PACE organizations in all phases of development and operations. Coupled with our recent addition of health plan management services, their joining our company means we can now offer a comprehensive menu of services for PACE organizations."   

Capstone Performance Systems Now Offers Health Plan Management and PACE Operational and Technical (TAC) Services

Capstone Performance Systems now offers a comprehensive menu of services to PACE organizations, from the exploratory/start-up stage through ongoing operations. 

Capstone's Peak Health Plan Management division provides services that optimize an organization's financial management and fulfill regulatory requirements for health plans. Services include enrollment management, encounter data processing and submission, claims adjudication, and Medicare Part D submissions and reporting. 

The PACE Technical Assistance Center (TAC) team has decades of combined PACE-specific experience. The team's provides services to help organizations in all phases of PACE-related growth, from exploring PACE, through developing and improving PACE operations. 
Matt Zimmerman
CMS Notifying Plans of Next Round of 1/3 Part D Financial Audits

By Matt Zimmerman
Director of Client Success/Part D Consultant

It's that time of year again. We have been advised that CMS is in the process of notifying PACE plans of their selection for the next round of 1/3 Part D Financial Audits. Selected plans will receive a notice from the CPA contracted to conduct this year's audits shortly. If your plan is selected for this round of Part D financial audits, the audit team will be focusing on Payment Year 2017. Preparing for this audit is time consuming and complicated, and many forms and requirements need to be finalized prior to the actual audit. 

Documenting Major Depressive Disorder 

By Denise Wills, CPC-A
Risk Adjustment Coder

When documenting depression, accuracy is important in determining the most specific code. If incomplete documentation is received, it will result in an unspecified code selection, which does not map to an HCC. For example, ICD-10 code F32.9 (MDD, single episode, unspecified) does not map to an HCC, whereas F32.0 (MDD, single episode, mild) does.

Capstone Welcomes New Staff Members

In addition to Kim Browning, Executive Vice President of TRHC; Patty Bailey, CEO of Peak Health Management Consulting; Indira Kanouka, MD, Medical Consultant; Dorothy Ginsberg, RN, PACE Consultant; and Mandy Hurley, Marketing and Enrollment consultant (see articles above), Capstone Performance Systems 
recently welcomed several additional staff members to the Coding and Auditing team. 

Medical Auditor Tiffany Mier, CPC, CPMA, CPPM, CRC, previously worked as an MRA Medical Coder at Conviva and Metcare/Humana. Bridget Byrd, RN, Risk Adjustment and Coding Specialist, served as a Case Management RN in the Community Transition Program (CTP) at United HealthCare. 

Two Risk Adjustment Coders also recently joined the Capstone staff. Elizabeth Palace, CPC, was a Medical Records Coder/HCC at Cigna Medical Group and a Quality HCC Coder at Scan Health Plan. Leonard Rollins, BS, CPC, was an HCC Coder for Optum - The CSI Companies and a multi-specialty Coder for MBS Consultants LLC.

Mark Your Calendar for Fall Conference Season with Capstone Performance Systems 

The calendar says its summertime, but at Capstone we're already thinking about fall conference season. We're making plans to sponsor and/or exhibit at a number of events. Be sure to say hello if you're attending any of the following!

August 7: CalPACE Member Dinner (Sacramento)
October 7-10: American Health Care Association Annual Convention & Expo (San Diego)
October 20-24: National PACE Association Annual Conference (Portland, OR)
October 25-27: American Academy of Home Care Medicine Annual Meeting (Rosemont, IL)
October 28-31: LeadingAge Annual Meeting & Expo (Philadelphia)
November 5-7: National Hospice & Palliative Care Organization Interdisciplinary Conference (New Orleans)
November 7: CalPACE Meet & Greet (Sacramento)

Clinical Documentation Excellence (CDE) Bulletin 

Capstone Performance System's Clinical Documentation Excellence (CDE) Bulletin, is a monthly e-bulletin with topics relevant to Primary Care Providers. Information typically includes clinical background, diagnosis tips, documentation requirements and ICD-10 coding guidance. Each month, the CDE Bulletin focuses on  a topic that is timely or requested by our clients. Recent issues explored Documentation and Coding for Skin Ulcers and Diagnosing, Documenting & Coding COPD . To suggest a topic, contact Richard Schamp, MD . Past issues are available on .

For more information on our services and how we can assist your organization, email or visit

© Capstone Performance Systems 2017. All rights reserved.

Richard Schamp, MD, Publisher/Executive Editor
Carla Davenport, MBA, MS, Editor

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