Risk assessment in Elation: empowering independent physicians to make more informed decisions in real time

Elation’s Risk Assessment feature, which allows users to track and manage their patients’ complexity using the Hierarchical Condition Category (HCC) system, is now available to all users using our Clinical First EHR.

This feature enables real-time decision support and is embedded into Elation’s electronic health record.  A patient’s score provides a snapshot of a patient’s health risk, and Elation has made this available at the point of care, automatically calculating each patient’s score based on information that providers have entered into the system.

Elation’s Risk Assessment score is based on the Hierarchical Condition Category (HCC) model used by the Centers for Medicare & Medicaid Services (CMS) to evaluate how sick patients are and conduct Risk Adjustment Factors (RAF). Introduced in 2004, HCC scores are central to determining reimbursement for the Medicare Advantage program and other Medicare programs like the Comprehensive Primary Care Plus (CPC+) program.

CMS’ methodology calculates a patient’s overall risk based on their demographic information (age and gender), current living situation (institutionalized versus in community) and billed ICD-10 codes for chronic conditions and comorbidities.

Whether your practice participates in value-based programs or not, HCCs and risk scores enable independent physicians to better identify, evaluate, and manage chronic conditions while also improving the accuracy of their documentation.

Elation utilizes information already captured by the practice (patient demographics and ICD-10 billed codes) to empower care teams to make more informed decisions in real time. With one click of a button, our system will automatically:

1. Display risk calculation prominently in the patient chart
2. Provide context of risk calculation by clicking on risk score
3. Break down risk by diagnosis and ICD-10 code
4. Highlight high risk problems not addressed in the current calendar year
5. Provide visibility into the eligible population and those who meet criteria for CMS reimbursement

For many practices, this translates into higher reimbursements and higher quality of care. HCC information and better documentation reflecting the full complexity of a patient panel often has a large revenue impact for practices, and empowers physicians to better manage patients needing chronic care.

One of the biggest advantages of using Elation’s Risk Assessment feature is that physicians using this feature have do not have to do any extra work to access its benefits. Care teams have the opportunity to receive assistance with care plan creation, quality measures and data analysis simply by turning on this feature. This makes assessing patient severity more straightforward than ever before.

We’re excited to bring our users a new feature that will save time, money, and most importantly, improve the quality of care for their patients. If you are interested in learning more about this feature, feel free to contact us via usersuccess@elationhealth.com or visit our help center.

Learn more about Elation’s Clinical First platform.