Managing HCCs for the right reimbursement

Sometimes close enough is good enough, but for those capturing and documenting high-risk patient diagnoses in the EHR, added specificity is key.
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HCC-Reimbursement

In the alphabet soup of healthcare IT, some acronyms matter more than others. When it comes to reimbursements, the importance of HCCs – Hierarchical Condition Categories – cannot be overstated. 

HCC codes lie at the heart of a payment methodology used by the Centers for Medicare and Medicaid Services (CMS) to determine capitated payments for Medicare Advantage and other Medicare programs. These codes allow payments to be risk-adjusted based on patient complexity, leading to increased payments for high-risk patients.

For providers, the implications are clear – the ability to document with greater specificity and precision can dramatically impact payments. Which begs the question: do your reimbursements truly reflect the work being done at the point of care?

To learn more about HCCs and how to effectively capture them in your EHR, download the white paper today.

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