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