Health Language Blog

Hierarchical Condition Categories Part 1: What’s all the Buzz About?

Posted on 07/13/16 | Comments

There is quite a bit of discussion around Hierarchical Condition Categories (HCCs) these days. And for good reason: as the risk adjustment model used since 2004 to determine reimbursement for various Medicare plans, the HCC framework is progressively being applied to numerous healthcare reform initiatives. In this two-part series, we break down the basics of HCCs, why they matter and how all healthcare stakeholders should respond to them going forward.

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Topics: clinical documentation, HCCs

2013 Terminology Trend Watch: A Mid-Year Update

Posted on 06/12/13 | Comments

At the beginning of the year, we presented three terminology management trends to watch for in 2013. You can read the full post here, but in summary, we predicted that the trends providers would be most focused on this year would involve: Meaningful Use; ICD-10; and a lesser discussed concept, Hierarchical Condition Categories (HCCs). 

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Topics: Meaningful use, ICD-10, HCCs, LOINC, Hierarchical Condition Categories, Trends, technology, RxNorm

The Emerging Role of Clinical Terminology Management for Payers

Posted on 05/03/13 | Comments

With the internal transition to ICD-10 well underway for most payers, now is the time to shift your focus to other industry initiatives, such as Stage 2 Meaningful Use. The move to ICD-10 has provided your organization with a breadth of granular codes, and it’s critical that you determine how best to incorporate these codes in your data strategy in order to maximize the benefits of this detailed patient and billing information.

Along with federal legislation, the rise in health information exchanges, ACOs and health insurance exchanges has shed light on the importance of data normalization beyond ICD-10. With interoperability at the heart of each of these initiatives, payers and providers alike will be required to use standardized terminologies for documenting and sharing patient information. Some of the most significant benefits of clinical terminology standardization and management for your organization in a value-based healthcare environment include:

  • More timely and accurate provider reimbursement due to consistent code usage;
  • Decreased administrative costs;
  • Streamlined communication with customers; and
  • Enhanced analytics for identifying cost-effective treatments offered by providers and supporting population health management.

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Topics: ICD-10, HCCs, Medical Plans, LOINC, medical terminology management

Top Three Terminology Trends to Watch For in 2013

Posted on 01/22/13 | Comments

With the recent presidential election behind us, 2013 promises to be a significant year for the healthcare industry. As the industry moves away from fee-for-service care and closer to value-based care, terminology management will be crucial for organizations to achieve compliance with industry regulations.

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Topics: Meaningful use, ICD-10, HCCs