March 10, 2020

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Succeeding in value-based health care requires juggling a lot of important tasks. You have to figure out new population health revenue streams and excel on quality measures, all while bringing care costs down below your previous spending. It can be overwhelming to get all the numbers to line up. Successful HCC capture can help you get there.

Hierarchical condition category, or HCC, coding is critical to making your ACO sustainable. HCC coding can make the difference between having an incomplete picture of your patients’ health or a full view of the severity and complexity of disease. Transparency into the disease burden and associated risk of your patient population can be the key to making your ACO numbers work.

A fair and accurate picture of your patients’ health allows your practice to stay competitive by fully accounting for the cost of patient care. Those costs will affect your benchmark, setting a level playing field when determining ACO cost savings. Effective HCC coding gives your ACO a fair shot at demonstrating the value of the care you deliver and earning shared savings.
So how does it work? Every member of the care team, including front office staff, nurses, physicians, billers and coders, IT professionals, and executive leadership, has a role to play. The care team knows the patient’s health status better than anyone and can select specific and accurate ICD-10 codes that drive HCC capture. This process of diagnosis reconciliation helps to demonstrate how sick the patient is, how much risk they represent, and how much their care will cost.  

If your ACO does not have the right process for capturing HCC codes, you are losing valuable patient information and may be losing out on shared savings as well. Caravan Health has robust HCC tools, proven methods, and practical support to help clients maximize their HCC coding opportunities. Contact a Caravan expert to learn more.

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