HCC RAF GAP Report

athenaClinicals

The HCC RAF GAP report allows you to report on the HCC RAF and gap scores for patients last seen in the specified timeframe. For more information, see User Guide — Patient Risk Adjustment and the Patient Risk Dashboard.

 

Display the Report Library: On the Main Menu, click Reports. Under General, click Report Library. Click the Clinicals tab. In the Standard Reports section of the tab, click run next to HCC RAF GAP Report.

 

 

 

To access reports on the Clinicals tab of the Report Library, you must have the Clinicals user permission and the Report: Report Library: Clinicals permission. The Report: Report Library: Clinicals permission is included in the following roles:

  • Practice Superuser role
  • Report Reader role

Note: To activate the HCC RAF GAP report, use the Activate Reports page.

 

 

  1. Display the Report Library: On the Main Menu, click Reports. Under General, click Report Library.
  2. Click the Clinicals tab.
  3. Click run next to HCC RAF GAP REPORT in the Standard Reports section of the tab.
    The Run Report: HCC RAF GAP REPORT page appears.
  4. Patient Last Seen Date — Enter the start and end dates for the report, or select a date range from the menu. Patients who were last seen during this date range appear in the report.
  5. Patient Status — Select the statuses of the patients to include in the report. By default, only active patients are included in the report, but you can also report on inactive, prospective, and deleted patients.
  6. Report Format — Select the format for your report results.
    • HTML table — Display the report results on your screen.
    • Text (tab-delimited) — Export the report results to a .csv file in tab-delimited format.
    • Text (comma-delimited) — Export the report results to a .csv file in comma-delimited format.
  7. Report Options — Select report options.
    • Suppress Column Headings — Select this option to remove column headings from the report results.
    • Suppress Report Name — Select this option to remove the report name from the report results.
    • Show Filter Criteria — Select this option to include your selected filter criteria in the report results.
    • Run Offline (will appear in your Report Inbox tomorrow morning) — Select this option for very long reports. Reports that are run offline appear in your Report Inbox the morning after the request.
  8. Click Run Report.

 

 

The Hierarchical Condition Category (HCC) model assigns a risk adjustment factor (RAF) to chronic conditions common in Medicare patients. The combination and number of patient diagnoses is then translated to a total RAF, which insurance companies use to determine the annual payment for the patient. You can view HCC RAF information during the point-of-care workflow, including diagnosis-level RAF weights and patient RAF scores, and using the HCC RAF GAP report.

Note: HCC diagnoses must be captured each 12-month calendar year to count toward risk adjustment for that year. All athenahealth HCC features reset on January 1 of each year because a patient's risk score is calculated over the course of a calendar year.

 

For more information, see Patient Risk Adjustment and the Patient Risk Dashboard.

 

 

Run Report: HCC RAF GAP REPORT
Patient Last Seen Date

Enter the start and end dates for the report, or select a date range from the menu. Patients who were last seen during this date range appear in the report.
Patient Status By default, only active patients are included in the report, but you can also report on inactive, prospective, and deleted patients.
Report Format

Select the format for your report results.

  • HTML table — Display the report results on your screen.
  • Text (tab-delimited) — Export the report results to a .csv file in tab-delimited format.
  • Text (comma-delimited) — Export the report results to a .csv file in comma-delimited format.
Report Options

Select other options for your report results.

  • Suppress Column Headings — Select this option to remove column headings from the report results.
  • Suppress Report Name — Select this option to remove the report name from the report results.
  • Show Filter Criteria — Select this option to include your selected filter criteria in the report results.
  • Run Offline (will appear in your Report Inbox tomorrow morning) — Select this option for very long reports. Reports that are run offline appear in your Report Inbox the morning after the request.
Column Headings
Patient Enterprise ID

athenaOne patient enterprise ID. The enterprise ID represents the entire patient record across all provider groups.

Note: If your organization does not use provider groups, this column displays the athenaOne patient ID number.
Patient Chart ID

Chart ID for this patient. If a patient sees providers in more than one provider group, the patient may have separate charts within the enterprise organization (for example, a chart for internal medicine and another chart for behavioral health).
Patient First Name

First name of the patient.
Patient Last Name

Last name of the patient.
Patient Date of Birth

Patient's date of birth.
Patient Status Status of the patient: Active, Deleted, Inactive, or Prospective. You select the patient statuses to include in the report using the Patient Status field on the Run Report: HCC RAF GAP REPORT page.
Patient Last Seen Date Date that the patient was last seen by your organization.
Primary Provider Primary provider for this patient, as specified in the Usual provider field on the Quickview.
HCC RAF score HCC RAF score for this patient, as shown on the Patient Risk dashboard (click the Problems tab in the patient chart and then click the view more icon to display the Patient Risk dashboard).
HCC GAP score HCC gap score for this patient, as shown on the Patient Risk dashboard (click the Problems tab in the patient chart and then click the view more icon to display the Patient Risk dashboard).

 

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