Hierarchical Condition Category: Calculate Risk Scores and Predict Costs

HCC enables healthcare organizations to more accurately calculate risk among their patients, which in turn allows them to better predict what they will spend on patient care.

Features and Benefits

eClinicalWorks® offers a module that enables practices to implement HCC.

With the HCC module, users can identify coding gaps based on historical data and secondary manifestation codes and display information at the point of care.

Users can also calculate patients’ Risk Adjustment Factors (RAF) scores; filter patients by RAF, provider, or insurance; view a trending analysis; compare RAF scores from current and previous years; and contact patients using integrated Patient Engagement tools.

The eClinicalWorks HCC Module

  • Identifies coding gaps on historical coding data and secondary manifestation codes, and displays information at the point of care.
  • Lets provides contact patients directly using integrated Patient Engagement Tools.
  • Calculates real-time, patient-level RAF score.
  • Allows user to filter patients by RAF, provider or insurance.
  • Provides an HCC dashboard for trending analysis, enabling comparison of RAF scores from the current and previous years.

Customer Success With HCC

See how HCC coding, Chronic Care Management tools, and other Population Health solutions helped Innova Primary Care succeed in the Medicare Shared Savings program.