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Streamlining Value-based Care: Improving Provider Efficiency and Patient Outcomes with AI-enabled HCC Coding

Iris Platform Solution:

Iris Code

Results:

+77%

Annual addressal of chronic condition capture

+33%

Annual addressal of new and emerging condition capture

Testimony:

“The process of having an alert on the patient banner is helpful in several ways. It serves as a reminder to be aware of the known HCC diagnoses. Even more helpful is the fact that it can alert a provider to HCC diagnoses from outside sources that result in better care and more comprehensive patient management”

Dr. Dale Steinmetz MD

Physician lead and Clinical Lab Director

Client Overview

A multi-specialty regional health system with a network of approximately 2,000 providers. The system serves a diverse range of patients and is engaged in several value-based contracts for Medicare patients, focusing on improving care delivery and patient outcomes through efficient, cost-effective strategies.

The Challenge

The health system faced challenges in driving provider engagement within its value-based care initiatives, particularly with the adoption of new workflows and product solutions. With multiple EMRs in use across their network, providers struggled to integrate new systems and workflows into their existing practices. They also felt burdened by large patient panels and the extensive requirements of value-based care, seeking a more efficient, user-friendly solution that wouldn’t distract from patient care or add to their already heavy workloads.

The Solution

Onpoint provided a comprehensive HCC coding solution, Iris Code, for over 250 providers. Iris code summarized years of clinical data—such as lab results, medications, and imaging studies—into actionable, value-accretive code opportunities that were customized to the system’s needs. By distilling vast amounts of clinical information, Iris Code simplified workflows and saved providers valuable time, reducing clicks and allowing them to focus on advancing clinical care plans. Built by providers for providers, this integrated solution accelerated performance improvement by addressing the needs of the clinicians directly within their established workflows.

The Results

As a result of the Iris Code implementation, our client saw a 77% improvement from baseline in the annual addressal and capture of chronic conditions. Additionally, there was a 33% improvement in the addressal and capture of newly identified and emerging chronic conditions, enhancing the quality of care and supporting ongoing performance improvement efforts within the system.

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