A competitive advantage for value-based reimbursement

3M™ 360 Encompass™ Patient Insights Suite - A competitive advantage for value-based reimbursement

Win in value-based reimbursement

As healthcare payments shift to value-based reimbursement (VBR) models, accurate hierarchical condition categories (HCCs) can improve performance and optimize patient care.

Patient Insights helps physicians, revenue cycle managers, and care coordinators and managers capture more complete HCC information in documentation and claims. Improved HCC capture gives health systems a competitive advantage in the new world of value-based payment.

  • More effectively manage HCCs for accurate reimbursement

    HCCs determine financial benchmarks in many value-based payment models, such as:


    • Medicare Advantage
    • Medicare Shared Savings ACOs
    • Commercial ACOs
    • Primary care medical homes

     

    Some Medicaid agencies and commercial payers use HCCs in contract negotiations when determining the risk of a population treated by a hospital or health system.

    • Patients missing HCCs do not have scheduled visits
    • No way to identify patients with HCC gaps
    • Inability to access patient information contained in disconnected EMRs
    • An HCC diagnosis is documented but not coded

    HCCs are calculated for a patient over an extended period of time, across all healthcare channels: inpatient, outpatient and clinics. It ensures all relevant conditions are treated, evaluated or managed, documented, coded and billed annually in at least one type of care setting.

  • 3M 360 Encompass Patient Insights Suite improves care coordination by:


    • Identifying patients with missing HCCs and low RAF compared with previous years
    • Providing a common patient profile across all care settings and disparate EMRs
    • Alerting PCPs at the point of care about undocumented diagnoses
    • Prioritizing high-risk patients who need to be scheduled
    • Coordinating care by using case tracking tools
    • Calculating the potential RAF increase for capturing complete HCCs

Looking for more?


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  • To request a complimentary demonstration of 3M 360 Encompass System Patient Insights Suite, please fill out the form below, and a 3M representative will contact you.

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