4/17/2023 0 Comments M.e.a.t. checklist hcc![]() ![]() To help prioritize, leading groups filter their data by payer, visit type, provider specialty, and patient complexity to determine which encounters have the potential to be the highest yielding from a risk adjustment standpoint. For most groups, it’s not realistic to prepare every provider for every patient visit, and then conduct a post-visit review of all provider documentation. Retrospective review can be costly and time consuming. Most leading Population Health Managers find it most cost-effective and efficient to focus on prospective and concurrent processes, such as chart prep and charge review. Some important items for consideration include the number of value-based contracts, priority of value-based contracts based on risk level, number of patients, number of providers, current population health staff (such as care coordinators and HCC coders), and the technology available. They’ll need to consider prospective, concurrent, and retrospective efforts in the context of their unique situation and the resources they have available. Increased Coder Productivityīefore creating an HCC coding strategy and aligning it with the risk run dates, groups need to determine what can be realistically accomplished to ensure the most complete and accurate HCC coding capture. ![]() These are good milestone dates at which to reassess current HCC coding capture progress and determine any next steps needed to stay on track. Top-performing groups often structure their HCC coding strategies around the four main due dates associated with the CMS schedule of initial, mid-year, final, and interim final risk score runs. To help ensure complete HCC coding capture and risk adjustment success, we’ve identified the coding review priorities these groups are focusing on right now. Most top-performing groups already have effective clinical processes in place (i.e., chart prep and pre-visit planning) and are ready to delve into the next layer of analysis and execution for stronger HCC coding capture and more accurate RAF scores. So, how do top Population Health Managers set their groups up for success? All previously captured HCC codes are now potential missed opportunities that need to be recaptured. The start of a new year brings with it a new set of challenges for Population Health Managers. ![]()
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