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Success Story: Focus More on Care and Less on HCC Coding

Community Health Network sees financial impact of more than $11 million

By implementing Hierarchical Condition Category (HCC) coding alerts to suggest clinically appropriate codes not previously documented, Community Health Network realized a financial impact of more than $11 million. They made this positive financial impact by:

  • Implementing new Hierarchical Condition Category (HCC) Coding approaches that allow for scoring and classifying of at-risk members to help more accurately estimate costs for the next year of coverage, thereby impacting next year’s payments.
  • Improving risk scores by focusing on providing cognitive activity within the workflow with clinical decision support engine evaluations.
  • Recognizing 10 new actionable HCC alerts resulting in a 57 percent average follow rate.

Download this success story to gain insights on how improving coding accuracy and facilitating appropriate documentation decisions can help you improve reimbursement.


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