Live & Recorded Virtual Event
Overview
Hierarchical Condition Categories (HCCs) have shaped risk-adjusted payment since 2004 and are now integral to programs such as Accountable Care Organizations, Medicare Advantage, and the Affordable Care Act. But HCCs do more than influence reimbursement. Behind the scenes, diagnosis data are being used to create profiles of providers and healthcare organizations that reflect the severity of illness, complexity of care, and risk of the patient populations they serve. Those profiles can affect payment, performance comparisons, and regulatory scrutiny. For HIM and coding professionals, understanding how these profiles are built—and how their work shapes them—has never been more important.
Session Objectives:
At the conclusion of this presentation, participants will be able to:
- Explain the purpose and structure of Hierarchical Condition Categories (HCCs) and distinguish how risk adjustment is applied in Medicare Advantage and Affordable Care Act programs.
- Describe the factors that influence an individual’s risk adjustment factor (RAF), including demographics, documented conditions, disease hierarchies, interactions, HCC counts, and coding specificity.
- Identify opportunities for HIM, coding, and CDI professionals to improve the accuracy and integrity of risk-adjusted data through complete documentation, accurate coding, monitoring, auditing, provider education, and compliance activities.
Session Level: Intermediate Level
Course Info
Event Date
November 6, 2026
12:00 PM – 1:30 PM CT
* This event will also be available on-demand after the live webinar.
Total CEs
1.5
Domain(s)
Data Structure, Content and Information Governance
Pricing
WHIMA Member
$24
Non-Member
$30
Student
$12
WHIMA Member – an AHIMA dues-paying member who has selected Wisconsin as their Component Association (CA)
Non-Member – includes AHIMA dues-paying members from other AHIMA Component Associations (CA) as well as AHIMA Credentialed Non-Members
Group Discounts
WHIMA offers discounted rates to Members and Non-Members, including students, if the criteria are met:
- If 3 or more individuals from the same organization (not a health corporation) register together for the meeting, you will receive a discount of 5% for each registration. Example: The discount would be available if all three or more individuals were from the same physical location, i.e., Advocate Health Care. The three could not be from Advocate Health Care and other Advocate Aurora Health facilities.
- Group discounts are only available when all registrants are registered at the same time, on the same registration. Discounts are automatically reflected once three registrants are added to a single registration
If group contains more than 15 people, please contact us for assistance.
Speaker
Additional Information
AHIMA
This educational offering has been approved for continuing education credit for use in fulfilling the continued education requirements of the American Health Information Management Association (AHIMA).
AAPC
CEUs are accepted from programs sponsored by AHIMA national offices and the state or regional AHIMA branches. One hour of instruction is worth one CEU. A certificate of attendance or completion is necessary to show participation.
ACDIS
AHIMA CEUs that are CDI-related are accepted.
Register
In order to access this course, you will need to click on the button labeled “Register for this Course.“
Webinar Access Instructions
The live webinar access instructions will be included in the confirmation email that you will receive after you register.
How Do I Receive the CE?
During the week following the live webinar, all paid registrants will receive an email with the CE.
Register
In order to access this course, you will need to click on the button labeled “Register for this Course.“
Already Purchased Course?
If you have already purchased this course, then you will need to sign in to access and then click on the session(s) listed under Course Content.
Access instructions for the course will be emailed to you within 2 business days following receipt of payment.
You will have 60 days to access the course after access has been granted.
How Do I Receive the CE?
You must click on the button labeled “Mark Complete” at the bottom of each course page before the CE will appear on the My Certificates page.
- For on-demand events, access instructions for the course will be emailed to you within 2 business days following receipt of payment.
- You will have 60 days to access the course. If your course has expired, and you need an extension, please contact us.
- You must click on the button labeled “Mark Complete” at the bottom of each course page before the CE will appear on the My Certificates page.
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Course Content
