HCC

In an era of accelerating medical costs and flat payments from CMS, accurately reflecting the health status of your members through proper HCC (Hierarchical Condition Category) management is the only way for your Medicare Advantage plan to remain financially viable in the Part D era.

The Medicare risk adjustment payment system uses HCC clinical coding information to calculate risk premiums for Medicare Managed Care Organizations. The single most important action your plan can take to improve both quality of care and ensure proper payments from CMS is mastery of the HCC system. Leprechaun™ HCC management solutions will help you be proactive in managing your HCC performance, working with providers to ensure complete and accurate coding — to find legitimate payments that every Medicare Advantage plan currently fails to recognize.