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By Eric McGuire
November 2, 2023
Hierarchical Condition Category (HCC) coding, originally designed by the Center for Medicare and Medicaid Services (CMS), plays a pivotal role in estimating healthcare costs, managing patients with multiple chronic conditions, and supporting the transition to value-based care. It helps provide a complete picture of the health status of a patient to enable physicians and health plans to better predict the resources required to manage and treat the patient.
However, implementing HCC coding and risk adjusted coding programs comes with its own set of challenges to navigate to ensure accurate and efficient coding. These include:
To overcome these challenges, healthcare organizations are encouraged to adopt the following best practices.
Implementing HCC coding and risk adjusted coding programs presents healthcare organizations with challenges that require strategic solutions. By adopting best practices that address provider engagement, embrace technology, expand document scope, and leverage AI tools, hospitals and health systems can navigate these challenges more effectively to ensure accurate coding and improved reimbursement rates. In the era of value-based care, mastering HCC and risk adjusted coding is a critical step towards providing a high-quality healthcare experience while effectively managing costs.
Learn more about applying HCC and risk adjustment coding with medical coding software in our on-demand webinar, Addressing Challenges in Implementing HCC Coding.
AGS Health is more than a revenue cycle management company–we’re a strategic partner for growth. By blending technologies, services, and expert support, AGS Health partners with leading healthcare organizations across the US to deliver tailored solutions that solve the unique needs and challenges of each provider’s revenue cycle operations. The company leverages the latest advancements in automation, process excellence, security, and problem-solving through the use of technology and analytics–all made possible with college-educated, trained RCM experts. AGS Health employs more than 10,000 team members globally and partners with more than 100 clients across a variety of care settings, specialties, and billing systems.
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