Rod Christensen, MD is a board-certified family medicine physician with over 25 years of practice. For the last 12 years, he has held a variety of operational leadership positions in Allina Health, including leading primary care, with a focus on clinical quality and patient experience. He currently serves as Vice President of Medical Operations, where his focus is on Triple Aim performance on risk-based contracts for Allina Health and for the Allina Integrated Medical Network (AIMN). He serves on the AIM Network Board of Directors and chairs the Clinical Performance Committee.
The Hierarchical Condition Category (HCC) risk adjustment model is used by CMS to estimate predicted costs for Medicare beneficiaries, and the results directly impact the reimbursement healthcare organizations receive. CMS requires that all qualifying conditions be identified each year by provider organizations. Documentation that is linked to a non-specific diagnosis, as well as incomplete documentation, negatively affects reimbursement. Despite providing care to a patient population that is not significantly less complex than the national population, Allina Health’s HCC coding for CMS risk adjustment was historically lower than both national and regional averages for Medicare ACO cohorts. Discover how it optimized its EMR, data, analytics, and provided widespread education to enable better documentation of care for patients with chronic diseases, leading to more accurate HCC risk adjustment coding—and more appropriate compensation for the quality care it provides.