Clinical documentation · Production

Notable Health AI-powered HCC Chart Review helps Security Health Plan capture 2,800+ additional conditions annually

The problem

Security Health Plan and Marshfield Clinic Health System needed a systematic way to identify Medicare Advantage members' disease acuity at scale; manual chart review was time-consuming and documentation of persistent HCC codes was incomplete.

Workflow diagram · grounded in source
1
Point-of-care EHR trigger
trigger
“Notable's integration into point-of-care workflows within the EHR”
2
AI chart data analysis
ai_action
“Security Health Plan leveraged Notable's artificial intelligence platform to incorporate structured and unstructured data in risk adjustment opportunity identification”
3
New condition suspecting
ai_action
“Notable's suspecting tool for new condition discovery also identified 440 conditions that were addressed and submitted by providers in the first eight months of 2024”
4
Actionable evidence displayed in EHR
output
“it embeds concrete evidence directly from the patient's chart in the provider's Electronic Health Record (EHR) workflow”
5
Provider reviews and documents conditions
human_review
“presenting results to providers in an actionable format that improved accurate clinical redocumentation of persistent HCC codes by more than 6%”
6
Conditions submitted for risk adjustment
output
“This provider documentation of conditions addressed at the point of care translates to an additional $5.4M annually, reflects the disease acuity, and enables Security to provide additional benefits”
Reported outcome

Security Health Plan captured 2,800+ additional conditions annually across 15,000+ reviewed members, generating $5.4M in additional annual revenue from provider documentation and $1.7M from newly identified conditions.
Marshfield Clinic Health System saw a 6.4% increase in accurate HCC documentation, and Security is now on pace to meet its documentation goals for the first time in several years.

Reported metrics
additional conditions captured annually (Security Health Plan)2,800+
Members reviewed15,000+
Additional annual revenue from provider documentation$5.4M
Additional annual revenue from new condition discovery$1.7M
Show all 12 reported metrics
additional conditions captured annually (Security Health Plan)2,800+
members reviewed15,000+
additional annual revenue from provider documentation$5.4M
additional annual revenue from new condition discovery$1.7M
per-member per-year improvement$467 per member per year
increase in accurate HCC documentation (Marshfield)6.4%
additional conditions captured annually (full Marshfield system)approximately 7,000
new conditions identified in first 8 months of 2024440
clinical redocumentation improvementmore than 6%
patient engagement rate (first week)13.4%
enterprise-wide deployment timeunder three months from kickoff
manual chart review time avoidedhours of manual chart review work avoided
Reported stack
NotableElectronic Health Record (EHR)
Source
https://www.notablehealth.com/customer-stories/customer-story-security-health-plan
Read source ↗

Frequently asked questions

What did this team achieve with this AI workflow?

Security Health Plan captured 2,800+ additional conditions annually across 15,000+ reviewed members, generating $5.4M in additional annual revenue from provider documentation and $1.7M from newly identified conditions.

What tools did this team use?

Notable, Electronic Health Record (EHR).

What results were reported?

additional conditions captured annually (Security Health Plan): 2,800+; Members reviewed: 15,000+; Additional annual revenue from provider documentation: $5.4M; Additional annual revenue from new condition discovery: $1.7M (source-reported, not independently verified).

How is this clinical documentation AI workflow structured?

Point-of-care EHR trigger → AI chart data analysis → New condition suspecting → Actionable evidence displayed in EHR → Provider reviews and documents conditions → Conditions submitted for risk adjustment.