Inferscience offers the best HCC Coding and Risk Adjustment services in Newton, MA. In this PDF, we will provide detailed information about how driving provider engagement in HCC coding and risk adjustment. If you provide the right tools and apply the recommended motivation tactics, it is important to maintain provider engagement by measuring results (data & more data!). You will need to provide weekly or monthly reports and feedback to your team to analyze not only what is improving but what needs improvement as well. Following an approach of analysis, planning and execution can help you achieve better goals for your team.

1. Driving Provider Engagement in HCC Coding
and Risk Adjustment
Although revenue from risk-based contracts continues to increase for medical groups of
all sizes, motivating providers to fully participate in their organization’s risk adjustment
efforts remains a challenge for healthcare organization leaders. Because of this, many
organization leaders have started looking for different ways to motivate their teams of
providers to drive better engagement in HCC Coding & risk adjustment documentation.
In our first blog post of this series, we discussed the importance of HCC coding and
optimal documentation, its challenges, and the role of the individual provider.
In this blog post, we look at steps that healthcare organization leaders can take to help
ease the documentation burden on clinicians, maintain team motivation, and ultimately
improve the organization’s HCC coding practices and bottom line.
Making HCC Coding Easier: Start with the Right Tools
Managing the complexities of risk adjustment documentation is difficult without the use
of technology. When clinicians aren’t equipped with the right analytics, coding, and
documentation tools, medical groups are at risk for underpayments or lost revenue
through clawbacks. Although provider organizations usually turn to their EHR for risk
adjustment solutions, many EHR companies have been slow to optimize provider
workflows to assist with HCC coding and documentation. Further complicating the issue

2. are EHRs that block the free exchange of information, and offer little to no clinical
support.
All of that is changing, however. Although EHRs are beginning to offer native HCC
coding functionality, it’s important to keep in mind that EHRs are primarily charting tools,
not purpose-built analytics and coding platforms.
To make clinical documentation easier for providers, it is essential to equip providers
with the right HCC coding tools. Since EHRs to this date don’t provide enough
functionality for optimal HCC coding, it has become necessary to add tools that will
automate the process and increase documentation accuracy. An EMR-integrated tool
such as Inferscience’s HCC Assistant is ideal.
The HCC Assistant analyzes both clinical and claims information to provide clinicians
with HCC coding guidance based on a 360-degree view of the patient’s condition. The
HCC Assistant’s NLP-based rules engine performs a prospective analysis of patient
information found within the EHR, as well as a retrospective analysis of submitted
medical claims, to instantly identify and close HCC coding gaps. The platform also
performs real-time risk adjustment factor (RAF) scoring to suggest how codes selected
can impact the RAF score for a patient, thereby predicting future funding and
expenditures. Inferscience’s most robust integration for the HCC Assistant is with
athenaClinicals, but the platform integrates with Dr. Chrono and Allscripts EHR as well.
Having the right tools is one of the most important ingredients for a perfect HCC Coding
recipe, but this ingredient won’t be enough without internal practice contribution to try to
keep providers engaged in HCC coding improvements, so, how do we motivate
providers to participate in HCC Coding & HCC Risk Adjustment?
Motivation is Key
One of the most important aspects of driving providers’ engagement in HCC coding
documentation is keeping the team motivated as well. We put together a few motivation
tactics that are working for different healthcare organizations:
1. Accountability:
To maintain accountability, Health Catalyst suggests driving HCC coding improvement
with the use of interdisciplinary workgroups. Workgroups can be formed with members
of the analytics team, clinicians, clinic managers, operations, and medical coders. The
use of interdisciplinary groups provides an easy teamwork solution to make sure
everyone is keeping each other accountable to improve the practice’s HCC coding as a
whole. A great addition to interdisciplinary workgroups can be assigned a practicing
Physician Advisor. The Record magazine suggests assigning a Physician Advisor with a
good relationship with the medical staff, good communication skills, and proper
documentation skills can positively impact documentation behavior for provider teams
and keep them motivated to follow best documentation practices.

3. 2. Inform and Educate:
It is important to keep your team informed about the current CMS regulations and
proposed rule changes, as well as educate them about any new tools you decide to
incorporate. For example, an organization using the HCC Assistant can provide
education sessions on the benefits of using the tool, as well as different “how-tos” when
using the HCC Assistant.
3. Incentivizing:
As mentioned in an article by AAFP, “Hospital, group, and health system employers
increasingly are paying physicians based on how their system performs in value-based
care. In this environment, risk adjustment can greatly affect physician income, so it is
important to get it right.” When incentives are provided it is easier to see a clear and
immediate result of hard work. This can also lead to an impact on the patient. Douglas
Conrad explains in his article in Health Services Research, based on empirical
research, that value‐based adjunct compensation incentives place a strong emphasis
on patient experience.
Maintain Engagement
If you provide the right tools and apply the recommended motivation tactics, it is
important to maintain provider engagement by measuring results (data & more data!).
You will need to provide weekly or monthly reports and feedback to your team to
analyze not only what is improving but what needs improvement as well. Following an
approach of analysis, planning and execution can help you achieve better goals for your
team.
Following the suggested techniques will not only benefit healthcare organizations but
patients and payers as well, as the risk adjustment model is a cycle that affects or
rewards everyone involved. These are some of the steps we recommend you follow to
make provider’s HCC coding & documentation easier, keep them motivated and
maintain engagement. In our last blog post of the series, we will focus solely on
providing guidance, useful information, and the differentiation between tools that are
used to improve HCC coding.