PRACTICE MANAGEMENT INSTITUTE
10223 MCALLISTER FWY, SUITE 104
SAN ANTONIO, TX 78216
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Improve Revenue with HCC Coding
The CMS Risk Adjustment Model includes almost 80 Hierarchical Coding Conditions (HCC) categories of chronic illnesses with thousands of diagnosis codes. These HCC codes impact physician reimbursement through the RAF score which affects every physician's reimbursement no matter what CPT code is billed.
The instructor will review an HCC Quick Reference Guide, M.E.A.T. guidelines, teach participants about the Risk Adjustment Factor (RAF), and share coding strategies for success.
Participants will learn:
the concepts of risk-adjusted diagnosis coding
how coding to the greatest level of specificity changes your reimbursement
why the accurate reporting of the severity of illness is so important
Turning Data into Dollars Through Quality Improvement
Healthcare quality improvement is more than a regulatory requirement. It is a pathway to better patient outcomes and stronger financial performance. This session provides a practical overview of how quality initiatives, guided by CMS and public-sector programs, create opportunities for medical practices to improve care delivery while earning valuable incentives.
Help your practice to thrive in a value-based world.
Learn how to navigate quality measures, national benchmarks, and reporting programs to position your practice for success in today's value-driven environment.
Highlights:
How U.S. healthcare quality compares globally
Goals and priority areas of the CMS National Quality Strategy
Understanding NCQA standards, HEDIS measures, and STAR ratings
How data drives the Quality Payment Program (QPP)
Strategies for maximizing performance in value-based programs
Engaging patients as active members of the care team through shared decision making
The role of care management in driving quality outcomes and improved patient experience
Overview of key terminology and acronyms in healthcare quality
Leveraging data analytics to identify performance gaps and track progress
Addressing social determinants of health to advance equitable care
Connecting quality improvement efforts to financial sustainability
Preparing for future trends: digital quality measures, AI, and evolving CMS priorities
Target Audience
Whether you are a provider, manager, or practice leader, this program will help you translate quality initiatives into measurable results that contribute to your healthcare organization's success.