- How smarter clinical terminology improves documentation accuracy
- Strategies to reduce mental fatigue by streamlining patient data
- Why proactive coding tools help prevent costly denials
- How point-of-care solutions strengthen payer-provider collaboration
Clinician burnout isn’t just about long hours or demanding caseloads, it’s often a symptom of deeper, systemic inefficiencies.
As value-based care (VBC) becomes more central to healthcare delivery, organizations are feeling the strain of fragmented workflows and incomplete patient data. Coding gaps – like missing hierarchical condition category (HCC) codes or insufficient specificity – don’t just lead to claim denials; they contribute to delayed follow-up, manual queries, and missed care opportunities. The result? Increased administrative burden and growing frustration for care teams.
In our eBook, Beyond the burnout: How smarter health tech is supporting clinicians, we explore how integrated technology can reduce friction, improve documentation, and help providers and payers align around shared VBC goals.
Below is an excerpt from one of the timeliest chapters.
Enabling provider-payer collaboration for value-based care
The challenge
For providers, success in value-based care depends on reliable patient data, especially complete ICD-10 and HCC coding for accurate risk adjustment. However, data gaps and manual workflows make it hard for care teams to collaborate effectively, particularly when managing patients with chronic conditions.
When documentation lacks specificity, payers often ask care coordinators to follow up with clinicians, sometime manually through printed paper reports to accept/deny claims. This tedious process can delay necessary follow-up or screenings, increase the administrative burden, and strain relationships. Most importantly, it pulls physicians away from patient care. If these gaps go unaddressed, it becomes difficult to plan appropriate care, meet quality benchmarks, and secure appropriate reimbursement under VBC contracts.
What should be a shared goal – better outcomes at lower costs – becomes a cumbersome process, slowed down by data friction.
The solution
Supporting value-based care takes more than accurate documentation – it requires tools that help teams act on care gaps in real time. Innovative point-of-care coding solutions can surface missing HCC-related insights from prior encounters, unstructured notes, and even multi-payer gap reports. These tools help providers ensure diagnostic integrity through greater ICD-10 specificity and complete HCC capture during the patient encounter, strengthening clinical data accuracy and enabling comprehensive risk assessment downstream. This supports more accurate RAF scores and helps reduce the need for retrospective documentation requests.
Additionally, complete HCC capture at the point of care supports measures like HEDIS and Star Ratings and offers a more complete view of patient populations. The result is a more collaborative approach, fewer roadblocks, faster decisions, and the ability to execute on shared VBC goals with fewer manual interventions and stronger financial alignment.
