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An Emerging Management Trend for Medicare Advantage Plans [MAPs]
By Dr. David Edward Marcinko; MBA, CMP™
[Publisher-in-Chief]
So called Hierarchical Condition Category Management (HCCM) is an emerging healthcare management trend designed to accurately reflect the health status of Medicare Advantage Plan [MAP] members and to help them remain financially viable in Part D of the system.
HCCM Indications
Since the Medicare risk adjustment payment system uses clinical coding information to calculate risk premiums for Medicare Managed Care Organizations (MMCOs), HCCM seems best to address the following:
- CMS risk adjustment system.
- Strategic and financial implications for Medicare plans.
Assessment
Any initiatives required to effectively managed care under a risk adjustment payment system is ripe for HCCM and the key success factors associated with these initiatives.
Link: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2936901/
Conclusion
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Filed under: "Doctors Only", Drugs and Pharma, Managed Care, Practice Management | Tagged: HCCM, Hierarchical Condition Category Management, MAPs, Medicare Advantage Plans, Medicare HMOs, Medicare Part D |
The Leading Business Education Network for Doctors, Financial Advisors and Health Industry Consultants 
MAPs in 2012
Click to access medicare.pdf
Ann Miller RN MHA
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Hierarchical Conditions
Keep hierarchical condition categories in mind when you code.
http://www.kevinmd.com/blog/2016/09/keep-hierarchical-condition-categories-mind-code.html
Dr. David Marcinko MBA
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