Course Description:

Health care organizations continue to face increasing scrutiny around documentation, coding accuracy, and compliance within the Hierarchical Condition Category (HCC) risk adjustment model. As CMS intensifies oversight and Medicare Advantage plans face deeper audits, the need for precise risk adjustment coding has never been more critical. HCC and Risk Adjustment: Maximizing Accuracy and Compliance is designed to help coding professionals, auditors, providers, and compliance leaders strengthen their understanding of the risk adjustment process and improve the integrity of their documentation practices.

During this webinar, participants will explore the essential components of the CMS-HCC model, including how chronic conditions, documentation specificity, and the MEAT (Monitor, Evaluate, Assess/Address, Treat) criteria directly impact risk scores. We will discuss common pitfalls that lead to coding inaccuracies and audit vulnerabilities, along with practical strategies to enhance provider education and support compliant workflows.

Attendees will also gain insight into emerging trends in risk adjustment, including CMS regulatory updates, RADV audit implications, and best practices for ensuring high-quality documentation across care settings. Whether you are new to HCC coding or looking to refine advanced skills, this session will provide actionable tools to improve accuracy, reduce compliance risks, and support organizational success in value-based care.

Join us for an engaging, informative session that will equip you with the confidence and clarity needed to excel in today’s evolving risk adjustment environment.

Learning Objectives:

• Explain the fundamentals of the CMS-HCC risk adjustment model and its impact on Medicare Advantage and other value-based programs
• Identify high-risk chronic conditions and documentation requirements necessary for accurate HCC coding
• Apply the MEAT (Monitor, Evaluate, Assess/Address, Treat) criteria to ensure compliant and thorough clinical documentation
• Recognize common coding errors and audit vulnerabilities that can negatively affect risk scores and organizational compliance
• Implement best practices for provider education and workflow optimization to enhance coding accuracy and efficiency
• Analyze recent CMS regulatory updates and RADV audit trends to stay ahead of compliance requirements
• Develop strategies for improving organizational performance in risk adjustment while reducing compliance risks and maximizing revenue integrity

Areas Covered in the Session:

• Overview of the CMS-HCC Risk Adjustment Model
• High-Risk Chronic Conditions
• MEAT Criteria Application 
• Common Coding Errors & Audit Vulnerabilities
• Best Practices for Provider Education & Workflow Optimization
• Regulatory Updates & RADV Audit Insights
• Strategies for Improving Organizational Performance
• Fraud and Abuse Risks
• Technology Integration
• Live Q&A Session

Suggested Attendees:

• Healthcare Providers
• Medical Coders
• Certified Risk Adjustment Coders
• Biller
• Auditors
• CDIs
• ACOs
• Administrators
• Revenue Cycle Professionals
• Compliance Officers
• HIM Professionals
• Risk Adjustment Analysts
• Quality Improvement Teams
• Care Managers and Coordinators
• Medicare Advantage Staff
• Coding Supervisors and Managers
• Healthcare Consultants
• Practice Managers