Joni Dion presented an “Introduction to Medicare Advantage: CMS-HCCs” and discussed the Centers for Medicare and Medicaid Services’ Hierarchical Condition Categories.
The CMS-HCC methodology was introduced in 2004 for Medicare Advantage reimbursement and has predominately been associated with documentation and coding for Part B related to a provider’s practice. In recent years, HCCs have taken on a more significant role as many hospitals own physicians’ practices and have a vested interest in the financial return. The CMS-HCC methodology also has the potential of impacting quality scores for the hospital and the provider’s practice.
Visit the Arizona ACDIS page for more information.