Current HCC Coding Approach
- Manual processes
- Pulling charts ahead of a patient visit to look for conditions that should be captured
- Sticky note reminders
- Retrospective review after the visits
New HCC Approach
A Better Way
- Real-time, software using chart data
- Automatic during the encounter
- Recommendations delivered based on chart evidence at the right time in the clinicians existing electronic health record (EHR) workflow
Only alerted when there is a suggestion that may
help guide the provider to improve coding accuracy.
Community Health Network sees positive financial impact of more than $7 million with actionable HCC alerts. 2
Despite financial hardships of COVID-19, this health system had a financial impact with 10 actionable HCC alerts in 2020 and 33 alerts in 2021.
Medicare Advantage
$800 PMPM
Next Gen ACO
Next Gen ACO
(10% of attributed lives)
10 actionable HCC alerts resulting in
25,687 alerts triggered in 2020
57% average follow rate
$4,945,0003
33 actionable HCC alerts
21 HCC Categories
9,922 HCC codes documented
$2,397,0004
“The HCC alert was followed 64% and if you are familiar with alerts in an EMR, a follow rate of 64% is nearly a miracle. We shoot for 40-50% as a gold standard so to have it at 64% tells you that providers really were accepting of this workflow and the alert when appropriate.”
Patrick McGill, MD – Chief Analytics Officer, Community Health Network
Actionable HCC Alerts help providers identify new codes not previously documented.
Benefits of HCC Alerts
Available in EHR Workflow
Actionable HCC alerts are made available in the EHR at the point of care and are designed to assist a provider in identifying whether a new or different HCC code should be considered by a provider to optimize diagnosis coding.
Suggests New Codes
Our HCC alerts are not solely reliant on prior coding history, nor do they focus primarily on the recapture of codes. This helps enable providers to identify new codes that have not been previously documented by providers, which may result in a year-over-year increase in RAF scores.
Expanded HCC Content
We offer more than 40 HCC alerts covering a variety of conditions including diabetes, Alzheimer’s disease, benzodiazepine and opioid dependence, chronic kidney disease and more that can be made available as part of your clinical decision support (CDS) library.
Actionable Alerts
The alerts are designed to be actionable within the EHR workflow and built to limit the provider’s administrative burden by avoiding the need to remember to update the code later or navigate to a different part of the EHR to complete the task.
Provider Efficiencies
The alerts are designed to increase provider efficiencies across the care continuum, with the goal to help improve patient care, risk score outcomes, billing compliance and the potential to optimize Medicare Advantage reimbursement.“Remarkable results begin with great partnerships. Community Health Network and Stanson Health are a perfect example of bringing together technology for the improvement of performance while improving the provider experience.”
Patrick McGill, MD – Chief Analytics Officer, Community Health NetworkWhat Can Stanson’s HCC Solution Do For You?
Resources
Focus More on Care and Less on HCC Coding
Community Health Network Sees Financial Impact of More than $7 Million.
Video: Dr. McGill from Community Health Network Discusses HCC Alerts
Learn About Their Proven Strategy and the Financial Impact.
Community Health Network Succeeds with HCC Alerts
Gain Insights on the Multi-Million Dollar Financial Impact.
Blog: Small Changes, Major Results
Indiana Health System Boosts Bottom Line by $7 Million After Implementing HCC Alerts in Their EHR.