Case Study: A leading health plan improves HCC gap closure with Innovaccer's point-of-care risk adjustment

Key results

The challenge

A Texas health plan managing more than 1,000 senior living facilities relied on fragmented data systems and retrospective chart reviews, producing coding gaps and revenue leakage in its Medicare Advantage risk-adjustment programs.

The solution

The plan deployed Innovaccer's InNote to unify 12 disparate data sources and surface HCC gaps in real time during patient encounters, replacing retrospective review with point-of-care documentation prompts and automated compliance checks.

The results, in context

The plan improved MA-plan HCC gap closure by 14% and gained 1,673 additional RAF points across programs. It recaptured 10,497 previously dropped codes via claims, with 99% of the HCC improvements coming from previously missed opportunities.

Products used