A large multi-site hospital system participating in the Medicare Shared Savings Program (MSSP) since 2015 experienced a significant decline in earned and projected shared savings following a strong performance year.
Health system leadership was concerned that key performance indicators, including Annual Wellness Visit (AWV) completion and Hierarchical Condition Category (HCC) capture, were below benchmark levels, directly affecting risk adjustment accuracy and the organization’s overall value-based care revenue.
Recognizing the need for a structured, data-driven, and clinically grounded approach, the health system engaged Impact Advisors to design and implement a comprehensive HCC Optimization Program to strengthen documentation accuracy, elevate provider engagement, and establish sustainable governance for ongoing improvement.
Establishing the Foundation
The engagement began with a detailed assessment of the organization’s current state. Impact Advisors conducted stakeholder interviews, observed provider workflows, and performed baseline measurements across HCC capture, AWVs completion, and the overall consistency of claim documentation. These insights confirmed the need for a more coordinated model—with well-defined governance, operational alignment, and accessible performance data—to drive improvement.
Impact Advisors partnered with clinical, operational, analytics, and IT leaders from the health system to design a program that combined workflow redesign, Epic EHR optimization, and provider-focused education. The Impact Advisors team established a formal governance structure (including leadership committees and workgroups) to ensure alignment, prioritization, and accountability. This structure created the foundation for sustainable decision-making and reinforced shared ownership across the enterprise.
A central component of the engagement’s design phase focused on helping the health system make more effective use of Epic’s EHR capabilities. Working hand-in-hand with the client’s team, Impact Advisors implemented enhancements to Epic’s Healthy Planet solution, including upgraded reporting tools, embedded prompts to better capitalize on HCC opportunities during patient encounters, and new performance dashboards to support daily operational visibility and executive oversight. These tools enabled accurate patient identification, improved risk stratification, and more reliable tracking of HCC capture opportunities.
Complementing the technology and workflow changes, Impact Advisors created and delivered custom provider education rooted in real-world scenarios. Training programs explained not only how to document appropriately but also why accurate HCC capture is vital for patient care, risk scoring, and MSSP financial outcomes. Providers received hands-on instruction, role-specific resources, and communication that connected risk adjustment to their day-to-day work, helping establish engagement and trust across service lines.
Positive Impact
The engagement successfully addressed longstanding operational barriers to accurate HCC capture, improved visibility into performance, and strengthened provider ownership of documentation practices. What had previously been inconsistent or siloed processes became a coordinated, data-driven program supported by strong governance, transparent reporting, and standardized workflows.
Provider engagement—often the most challenging aspect of HCC improvement—was significantly strengthened through Impact Advisors’ tailored training and communication initiatives. By grounding education in real clinical scenarios and reducing variance in Epic workflows, providers gained clarity about documentation expectations and confidence in completing AWVs and accurately capturing chronic conditions.
Impact Advisors’ efforts also made HCC opportunities more visible at the point of care. New executive dashboards and KPIs provided leaders with real-time insights into trends, performance gaps, and HCC capture opportunities, enabling faster decision-making and a more proactive approach to risk adjustment. The results underscore the value of combining analytics, workflow redesign, and provider education into a unified transformation effort. The hospital system realized $40.0M in risk adjustment value, $16.1M in new shared savings, and 2,768 newly documented HCCs. These improvements reflect both the magnitude of the financial opportunity and the lasting operational value of the program developed by Impact Advisors.