Hierarchical Condition Category

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 secret to successful long-term risk adjustment for your Medicare Advantage plan is to properly educate your providers as to the value of complete and accurate Hierarchical Condition Category coding of every member, every year.

The Medicare risk adjustment payment system uses clinical coding information (Hierarchical Condition Category) to calculate risk premiums for Medicare Managed Care Organizations. Leprechaun™ HCC management solutions will help you be proactive in managing your Hierarchical Condition Category performance, working with providers to ensure complete and accurate coding.