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3 opportunities to optimize HCC capture

    Understand keys to success for HCC capture

    Coding and documentation are important under value-based reimbursement models because they inform Hierarchical Condition Categories (HCCs) and Risk Adjustment Factors (RAFs), which ensure appropriate compensation for treating high-risk beneficiaries. Physicians do most coding, so they have a central role to help organizations set accurate reimbursement rates through risk adjustment. High performing ACOs ensure important stakeholders across their organization understand the impact that accurate HCC capture has on value-based payments.

    This primer outlines explains the importance of HCC capture and highlights how three provider organizations improved HCC capture by:

    1. Educating physicians on the importance of HCC capture and how it impacts their reimbursement
    2. Offering coding support to physicians
    3. Implementing instant rewards tied to documentation accuracy

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