Improving Accuracy of Clinical Documentation Positively Impacts Risk Adjustment Factor and HCC Coding
Improving Accuracy of Clinical Documentation Positively Impacts Risk Adjustment Factor and HCC Coding
8 PagesCopyright © 201 8 Health Catalyst 1 Improving Accuracy of Clinical Documentation Positively Impacts Risk Adjustment Factor and HCC Coding EXECUTIVE SUMMARY The Hierarchical Condition Category (HCC) risk adjustment model is used by CMS to estimate predicted costs for Medicare beneficiaries, and the results directly impact the reimbursement healthcare organizations receive for patients enrolled in a Medicare Advantage plan. CMS requires that all qualifying conditions be identified each year by provider organizations. Documentation that is linked to a non-specific diagnosis, as well as incomplete documentation, negatively affects reimbursement. Allina Health, a not-for-profit integrated healthcare delivery system serving Minnesota and western Wisconsin, needed to improve its HC
