Healthcare Digest | Episode 7: HCC Coding Recapture

September 8, 2021

Hierarchical Condition Category (HCC) Coding Recapture

Valerie Ostrander | Manager, Mazars Healthcare Consulting Practice | Mazars
Amanda MacBride | Senior Consultant, Mazars Healthcare Consulting Practice | Mazars

Click Below to Watch this Video

Key Items Considered

  1. HCC Coding
    • What is HCC Coding
    • How HCC Coding Works
  2. HCC Coding Recapture
  3. Solving the Problem of Low HCC Recapture

Learn More

Hierarchical condition category (HCC) coding is a risk-adjustment model originally designed to estimate future health care costs for patients. The Centers for Medicare & Medicaid Services (CMS) HCC model was initiated in 2004, but is becoming increasingly prevalent as the environment shifts to value-based payment models.

Tracking HCC recapture is a critical part of a successful risk adjustment program as it provides actionable population health metrics: uncovering potential gaps in either access to care, care provided, or documentation thereof. Monitoring changes in the metrics allows plans to support their provider partners in setting-up targeted programs to understand and remediate the root cause(s) disrupting care. This, in turn, stabilizes risk adjustment revenue year over year, ensuring care is provided to meet the patients’ clinical needs. Furthermore, if conditions related to HEDIS and Stars are treated and under-documented, or even worse, under-treated, the benefits of tracking recapture, and the consequences of failing to do so, become much more serious.

Specialists from the Mazars Healthcare Consulting Practice discuss how HCC coding works, recapture and solving the problem of low HCC recapture, and more. Learn more or contact Mazars to connect with specialists to find out how Mazars helps healthcare organizations.

Contact: Valerie Ostrander Email:

Contact: Amanda MacBride | Email:



Disclaimer: While this recording and its materials are up-to-date as of this time of this presentation, please be advised that due to the fluidity of the current national emergency, information is rapidly changing. Mazars does not represent or warrant that this information will always be up-to-date, complete, or accurate. Any representation or warranty that might be otherwise implied is expressly disclaimed. The information presented is not legal advice. You are advised to seek professional and/or legal advice, as appropriate, from competent professionals and/or counsel licensed in your jurisdiction.




Related posts

Helping clients innovate and grow with experienced insight and dynamic solutions. In today's changing healthcare landscape, payers, providers and other stakeholders must successfully navigate regulatory and market challenges in order to transform their businesses into more profitable and effective organizations.

Read More

Safeguarding PHI and PPI, reducing risk, and meeting compliance. As the world continues to become more technologically interconnected, a wide range of businesses find themselves in possession of and required to defend, sensitive data that could be used to identify or contact their members, patients, and customers...

Read More

Join us for this virtual live broadcast December 16, 2021 | 12 PM ET Featured Presenters Flora Chao, Global Head of Funding, Treasury Market Operations | International Finance Corporation Anne Simpson, Managing Investment Director; Board Governance and Sustainability Member of the Investment Management Committee | CalPERS Jonathan Bailey, Head of ESG Investing

Read More

Copyright 2021 - Mazars - United States