The easiest way to improve HCC capture is to provide specialists with discrete lists of HCC codes for which they’re accountable. Specialists shouldn’t be accountable for all codes—just universal conditions any physician can identify—as well as their specialty-specific codes.

New York-based multispecialty group Crystal Run Healthcare has done this to great success, holding their specialists accountable to 16 core diagnoses:

Crystal Run’s core chronic diagnoses

This core list has remained consistent since implemented in 2019. Crystal Run maintains specialty-specific HCC capture lists for specialties such as oncology, neurology, and endocrinology, as those specialties should record the complex chronic conditions specific to their patients.

Educate specialists not just on the importance of HCCs for reflective reimbursement, but also as part of a bigger mindset shift of them to take a more population-focused approach to care. It’s easy for specialists to focus on their hyper-specialized areas of expertise. Education on HCC capture can help them better understand the costs and challenges of managing chronic conditions, encouraging them to collaborate more with PCPs to manage them.

Kettering Physician Network did so when they provided didactic and practical HCC education to their primary care and specialty physicians. These physician-led sessions included presentations on the importance of HCC capture, how it impacts reimbursement, and a “how to” walkthrough of incorporating documentation best practices into day-to-day workflows. Within four months of the program, Kettering improved HCC capture across their network by 31%.

When optimizing HCC capture in primary care, many organizations tied a portion of PCP compensation to HCC capture. This same practice can be applied to specialists. A common metric of success used is HCC recapture rate, but organizations have also paid physicians incrementally for each HCC documented. However, before implementing either approach, ensure it fits with your broader compensation philosophy.

And as your specialists become more comfortable with HCC capture, move away from financial incentives and toward a broader culture of accountability. Successful primary care programs have relied on performance transparency to create such a culture.

Accurate HCC capture requires significant time investment. At a minimum, provider organizations should develop a simple, easily-accessible resource featuring HCCs every physician can document—especially ones that are high-impact and often incorrectly coded. To maximize outcomes, advanced organizations invest in real-time analytic staff or technology-based coding support.

For example, Crystal Run created a tool that automatically identifies and alerts specialists to possible chronic care gaps prior to visits. The tool is fully automated and flags any patient with a chronic condition that has not yet been recorded in the current year. If a specialist believes the patient no longer has that condition, they can email the HCC team to close the care gap. Crystal Run has reaped the rewards of their HCC capture efforts. In 2020, they had an 88-90% HCC recapture rate, even during the pandemic—far above national standards.