Certified Risk Adjustment Coder (CRC)

What may occur if an MA plan focuses HCC capture solely from a retrospective approach?

1. Improved patient outcomes

2. Exhaustion from tedious chart reviews

3. Enhanced provider relationships

4. Increased coding accuracy

The correct answer is: Exhaustion from tedious chart reviews

Focusing solely on HCC (Hierarchical Condition Category) capture from a retrospective approach likely leads to exhaustion from tedious chart reviews because this method requires an extensive analysis of patient records after care has been provided. This approach often involves examining numerous charts to identify and document all relevant diagnoses that could impact risk adjustment. Retrospective reviews can be time-consuming, leading to a possible burnout among coders and clinicians tasked with this responsibility, as they may have to sift through many clinical documents without the immediate context of ongoing patient care. The labor-intensive nature of this process does not typically foster improved outcomes, enhanced provider relationships, or increased coding accuracy in the same manner as proactive or concurrent methods might. Thus, the impact of a solely retrospective approach is primarily characterized by the burden it places on staff engaged in these exhaustive reviews.