Improving Patient Care through Hierarchical Condition Category Documentation
Accurate Hierarchical Condition Category coding information helps create a more complete picture of the complexity of a patient population, improves the value of the problem list, and enables better management of a patient’s chronic diseases. And better documentation that captures the full complexity of the patient often results in appropriately higher reimbursement. Providers should be accurately documenting their patients using Hierarchical Condition Category (HCC) coding annually, and this project will help improve and track your accuracy.
The goal of this project is to improve the accuracy of documentation so that HCC scores are closer in congruence to our RAF scores within 3 months.
This online module has 3 stages requiring you to complete 2 Plan Do Study Act (PDSA) cycles, and you need to complete all three stages in order to claim credit. It will take approximately 3 months to fully complete this program.
Stage A: Participants will learn how to access their dashboard and identify the RAF gap score, and they will set their goals for improvement.
Stage B: Participants will learn how and when to use HCC coding. They will complete their first PDSA cycle and report their gap score after the first cycle.
Stage C: Participants will record their final gap score and reflect on the project.
This course is intended for all providers using Advocate Aurora electronic medical records.
At the end of this session, learners should be able to:
- Accurately document patients’ chronic diseases using HCC
- Assess their patient population using their HCC and RAF dashboard
- Assist and encourage other providers to accurately document patient conditions using HCC.
John Brill, MD; Vice-President, Population Health, WI, Advocate Aurora Health
Victoria Ruetten; Director Quality Improvement, Quality, Advocate Aurora Health
The planners and speaker(s) have indicated that there are no financial relationships with any commercial interests to be disclosed.
Accreditation Statement: Advocate Aurora Health is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.
Credit Designation Statement: Advocate Aurora Health designates this internet enduring activity for a maximum of 30.00 AMA PRA Category 1 credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
Maintenance of Certification: Advocate Aurora Health has been approved by the American Board of Medical Specialties (ABMS) as a Multi-Specialty Portfolio Provider (MSPP). This allows Advocate Aurora Health to award Maintenance of Certification (MOC) Part IV credits to those participants in this program who demonstrate active participation in this course. After verifying completion of all requirements and active participation, the Advocate Aurora CME Office will review and forward the form to the ABMS who will then transfer your credits to your Certifying Board.
- If you are certified by multiple Boards, this project will count towards all participating Boards (see https://cme.advocateaurorahealth.org/content/moc-recognition for specific information). You will need to provide the names of the Boards as well as your certification number for each Board you list.
- The attestations are frequently audited by the Boards, so please provide complete, thoughtful responses.
Upon successful completion and attestation, the CME Office will review your completed project. If it is completed satisfactorily, the CME Office will submit the project to the ABMS who will in turn submit the completion data directly to your certifying Board. It will take approximately one month for the completion to register with your Board.
PAs: This QI Effort meets MOC Part IV Standards and Guidelines for the ABMS Multi-Specialty Portfolio Approval Program Organization and is eligible for MOC Part IV through participating ABMS Member Boards and for Category 1 PI-CME credits through the National Commission on Certification of Physician Assistants.
- 30.00 AMA PRA Category 1 Credit™Aurora Health Care is accredited by the Wisconsin Medical Society to provide continuing medical education for physicians. Aurora Health Care designates this activity for a maximum of 30.00 AMA PRA Category 1 Credit(s)TM. Physicians should only claim credit commensurate with the extent of their participation in the activity.
- 1.00 MOC Part IV ProjectAurora Health Care has been approved by the American Board of Medical Specialties as a portfolio provider for Part IV Credits towards Maintenance of Certification. This applies only to those Boards participating in the MSPP Program. Check with your certifying Board for specifics. Any fees relating to Board Certification still apply.
First enroll in Improving Patient Care through Hierarchical Condition Category Documentation. Then you will be able to begin with Stage A.
This project is available to Advocate Aurora providers (employed and independent) only. Please use "Aurora Login" to access the project. If you need help enrolling or logging in, please contact the CME Office at firstname.lastname@example.org .