Yet Another Reason Why your HCC Score Matters

We all know MACRA is here. We are in the second performance year and our performance in 2018 will dictate our penalty or reward for 2020. MACRA is composed of two programs: APMs and MIPS. MIPS scoring is complicated, but check out this simplified graphic of the 2017 scorecard to get an idea.

See those bonus points available in the boxes on the right? Those are important. They allow providers to increase their raw score in the performance categories. Guess what? Starting this year, 2018, there are bonus points available for complex patients. Bonus points that will be added to your total MIPS composite score. Bonus points that will not be weighted, but will be an unadulterated bonus.

How can providers earn these bonus points for complex patients? HCC scores. CMS will calculate the bonus automatically by cross walking your ICD-10 diagnosis codes to Hierarchical Condition Categories (HCC) to produce an average risk score. In order to make sure that your providers maximize their chances of earning these bonus points for complex patients, make sure they are selected ICD-10 codes to the maximum level of specificity and report any applicable secondary diagnoses to capture full complexity and illness burden of the patient.

Interested in helping your providers? Click here to learn more.