HCC Management

Improve risk-adjustment documentation with comprehensive HCC management


The Hierarchical Condition Category (HCC) risk-adjustment model is becoming more important and increasingly challenging to healthcare organizations as it is gradually applied to not just Medicare Advantage (MA) plans but also Accountable Care Organizations (ACOs) and Hospital Value-Based Purchasing (HVBP) programs.

For accurate HCC coding, providers need to capture the complete diagnostic profile of every patient to ensure proper payment. Chart documentation is key to risk-adjustment payment integrity and accuracy as well as holistic understanding of the patient to drive better care quality and outcomes.

HCS Consulting’s HCC Management solution takes a multi-pronged approach to clinical documentation that continually evaluates, educates, monitors, and improves documentation quality. Our consultants leverage analytics to provide a comprehensive solution that delivers frontline assistance to physicians so that HCC opportunities are not missed while documenting the patient encounter as well as a back-end, concurrent audit solution to catch any HCC gaps before claims submission.


The capture of HCCs in the physician specialty clinic environment is critical for appropriately reporting the severity of the Medicare Advantage patient population, physician profiling and optimal reimbursement. Our solution will result in:

HCC Capture. Directly impact reimbursement by improving RAF scores and population health management.

Improved clinical outcomes. Accurately capture the severity of your patient population by improving your depth of coding and reporting of chronic conditions.

Improved data outcomes. Effective health management starts with accurate data outcomes which can only be accomplished through the integrity of your data.

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A consulting company providing solutions for Revenue Integrity to a diverse range of healthcare organizations nationwide. The company’s portfolio delivers quality solutions to empower healthcare organization success, enhance clinical and financial outcomes, and enable the transition to value-based healthcare.


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