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Clapping Audience

​Intelligence Brief: High-Value FFS Toolkit Part 1

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In this Part 1 of a three-part series, we explore high value FFS codes to support enhanced care management services, detailing eligibility and service requirements, billing and best practices.

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What's New

What's New In Health Endeavors 

Stay up-to-date with the latest enhancement and feature updates. 

2025 Analytical Data 

2025 analytic data is now live on your dashboard and fully integrated into all the quick reports. Your benchmarking is powered by the most recent CMS-published data—tailored specifically to your ACO.

 

Keep in mind that benchmarks are updated only when CMS releases the Aggregate Expenditure/Utilization Reports (EXPU). 

 

To ensure a clear matching of data to benchmarking to 2025 data, the benchmarks will be blank until the EXPUs are published for 2025. 

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As the claims line feeds are received, the diagnosis recapture will populate and update, providing that crucial recapture rate along with the average 2025 AVG HCC Score. 

Release Date: 3.12.2025

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​Patient Lookup Window 

The Patient Lookup - HCC Details are being updated. 

  • The Risk Score Impact will indicate the coefficient weight value for each HCC category.  â€‹

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Target Release Date: 1/13/2026

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Quick Report Updates

Carebotic Activity Log 

The Carebotic Activity Log report has been updated and now offers 2 export options 

  1. The Activity Details provides details on individual actions that were captured in the Carebotic. This export will now include the claim received date after the Carebotic ICD10 push action. 

  2. The Activity Summary will identify a high level summary of each TIN:  â€‹â€‹â€‹â€‹

    • Attributed patient count​

    • Attributed patient count that has at least 1 HCC that has not been recoded in the year 

    • Patient visits - indicated how many patients how many of the attributed patient population had a visit with a provider associated to the TIN   

      • Claim with an NPI that is associated to the TIN – must match network manager setup.   

      • Claim must be within the current year of the through date.   

    • Patient Action Count - how many unique patients has at least one action within the date range 

    • Lowest and Highest user engagement 

      • Data generated varies per user ID format that is provided by the EHR.
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Release Date Scheduled 02/03/2026

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The Patient Summary Quick Report 

The Patient Summary quick report has been updated to include the beneficiary demographic details. Along with these new updates we will be retiring the Beneficiary Demographics quick report.  

Same great data, one generated report:  

  • Patient Summary quick report updated  

  • Beneficiary Demographic quick report archived 

Release Date: 1/22/2026

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Effective Period Name Update  

 

The Effective Period filters used throughout the Health Endeavors portal will be renamed to improve clarity and help users better understand how these filters function when generating reports and dashboards. 

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The Patient Attribution Period filter will continue to represent the population of active or attributed patients within a selected time frame, based on Network Manager configurations for TINs, NPIs, CCNs, Divisions, and Subgroups. 

Please note that commercial populations do not have an effective period, as the portal displays only the most recently imported membership list for these populations. 

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Additional filter name updates include: 

  • Patient Population will be renamed to Payor Type 

  • Patient Attribution will be renamed to Patient Attributed Status 

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Target Release Date: 1/8/2026

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HCC Details and Summary Report   

We are excited to announce a new HCC Details and Summary quick report, designed to enhance visibility into performance in preparation for the transition to full v28. 

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Purpose: This new report retains the detailed diagnosis-level HCC insights, while expanding to include summary-level views at the patient, NPI and TIN levels.  A major enhancement includes identifying HCCs that are potentially co-managed by specialists providing visibility into shared care responsibility. 

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The Importance: This new report provides clear, actionable insights throughout the performance year to: 

  • Identify performance trends across panels and providers  

  • Monitor documentation and risk-capture efforts in more real time 
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Target Release Date: 12/4/2025

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2025 Risk Adjustment 

The 2025 HCC Risk Scores will be available in the Health Endeavors platform next week. These scores, calculated using the CMS-HCC risk adjustment model, help assess patient risk and optimize resource allocation.

 

To support your team, we have attached an educational resource outlining key updates, recapture rate insights, and platform tools available for accessing HCC data.

 

Release Date: 04/08/2025

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Recorded Webinars

2025 CMS Final Rule Webinar – Join the nationally recognized health policy expert and director of Managing Director of Medicare Services at HMA, Amy Bassano, for a in depth discussion about the 2025 CMS Final Rule. Watch Recorded Webinar

Thursday, December 5th at 2:00 EST

2024 All About Quality Webinar – Join our quality team as we break down all of the options and the step-by-step process of making your reporting season smooth and easy. Watch Recorded Webinar

Thursday, December 12th at 2:00 EST

Planning for 2025 Quality Webinar –Join our quality team as we break down your options and requirements for 2025.  Watch Recorded Webinar

Populations and Programs
  • ACO REACH 

  • Primary Care First (PCF) 

  • Medicare ACO 

  • Medicare Blue Button FHIR

  • Medicare DPC FHIR

  • Medicaid

  • Commercial

  • Medicare Advantage (MA)

  • Self-Insured Employer TPA

  • Remote Patient Monitoring (RPM)

  • Chronic Care Management (CCM)

Health Endeavors

P.O. Box 27290

Scottsdale AZ  85255

  • LinkedIn
888.862.0366

2024 Health Endeavors

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