Acuity Navigator

The Acuity Navigator is designed to provide directional data on how well is your population's true clinical complexity is being captured in CMS risk scoring.

Risk Adjustment Model - The HCC algorithms used in Health Endeavors are based on the CMS-HCC methodology.
Payor Type - Select the patient payer population you want to view, e.g., Medicare, Medicare Advantage, Self-Insured Employer, Commercial or Medicaid.

Patient Attributed Period - Select the period for the patients you want to view e.g., the active/attributed patients during that period. Effective periods apply to Accountable Care Organizations (ACOs) and ACO REACH populations, but not commercial populations as it shows only the most recently imported membership list. Effective Period is intended to display patients for the time period selected and the current year of data unless the Year of Service is changed to a different year.
Year of Service - Select the year of claims data you want to view, e.g., selecting 2026 will show claims from 2026 calendar year. Year of Service is intended to display the data for the year selected.

Division - Select a Division (groups of facilities setup in a group, created in Network Manager), if you are using divisions. You may select more than one.

TIN Name - Select TIN/Practice Name from the drop down. You may select more than one.

SubGroup Name - Select subgroup(s) (group of NPIs setup in Network Manager) if you are using subgroups. You may select more than one.

NPI - Select your NPI/Provider Name(s) from the drop down.

Once you have selected all your filters, click the 'Search' button to generate the Population Stats grid and additional aggregated grid options.

Filters

Population Stats | Facility TIN Summary | Provider NPI Summary

The Population Stats section is an overall view of the entire population. The same columns are applied at the Facility TIN and Provider NPI views.

Scorecard - A printable PDF scorecard of your population values that are displayed on the grid.

2025 AVG Risk Score - The average risk score for the assigned patients in the previous year. The risk scores are calculated using the diagnoses for the year displayed. The higher the score, the greater the expected healthcare needs and costs for that patient. This score is used to adjust provider payments to match the health status and predicted costs for beneficiaries.

2026 AVG Risk Score - The average risk score for the assigned patients in the current year. The risk scores are calculated using the diagnoses for the year displayed. The higher the score, the greater the expected healthcare needs and costs for that patient. This score is used to adjust provider payments to match the health status and predicted costs for beneficiaries.

2026 Recapture Rate - This column displays the total percentage of HCC diagnoses (recurring chronic condition codes) that we coded last year and have been recaptured in the current year.

Benchmark Leakage - Benchmark Leakage is the loss in benchmark caused by not capturing a diagnosis in the performance year that existed in your previous benchmark years. Providers must recode chronic diagnosis codes within their claims annually or they are removed from the beneficiary's risk score.

Top HCC w/ Benchmark Leakage - The top HCC category code and description that has the highest benchmark leakage.

Top Occurring HCC - The top HCC category code and description that has the highest count of patients.

# Pts Co-Managed - Total count of patients that may be potentially co-managed by a specialist provider. A patient is only counted once in this total but may be potentially co-managed by 1 or more HCC categories.
AWV Completion - The percentage of Annual Wellness Visits completed is based on a rolling 12 months. The % is based on patients that have at least 1 HCC diagnosis.

Patient Summary

A summarized view of your individual patients.

Scorecard - A printable PDF scorecard of your patients values that are displayed on the grid.

Last AWV - The date of the patients last annual wellness visit.
Upcoming Appointment - Talk to your Health Endeavors Client Success Lead to learn how to provide EMR AWV appt dates.

2025 AVG Risk Score - The patients risk score from the previous year.

2026 AVG Risk Score - The patient risk score for the current year selected.

Total Benchmark Leakage - Benchmark Leakage is the loss in benchmark caused by not capturing a diagnosis in the performance year that existed in your previous benchmark years. Providers must recode chronic diagnosis codes within their claims annually or they are removed from the beneficiary's risk score.
Potentially Co-Managed by a Specialist - Indicates if the patient has every been seen by a specialist for 1 or more HCC categories.

Recapture Rate - The HCC Recapture rate for the patient.

Physician Recapture Rate - Out of the total HCCs for the patient, how many were recaptured by a Physician.
APP Recapture Rate - Out of the total HCCs for the patient, how many were recaptured by an Advanced Practice Provider.
HCC Count - The total count of HCC categories that the patient has.
HCC Not Recoded - The count of chronic HCC categories that have not been recoded for the patient.
HCC Recoded - The count of chronic HCC categories that have been recoded for the patient.
HCC New - The total count of HCC categories that are new for the patient.

Details by Diagnosis

A break of details by HCC diagnosis.

HCC - The HCC category code.
HCC Category - The HCC Category.
HCC Description - The description of the HCC code.
HCC Coefficient Weight - The HCC Coefficient Value based on the patient’s dual eligibility and Medicare status code.
HCC Dollar Value - The HCC dollar value for New, Recoded, and not recoded
HCC Benchmark Leakage - This indicates the dollar value of benchmark leakage for the HCC category that was not recoded in the current year.
ICD10 - The ICD code that was diagnosed, that triggered the most recent coding of the HCC category.
ICD10 Code Description - The description of the above ICD code.
Recoding Status - HCCs that have been Recoded, Not Recoded, New, Overwritten.
Potentially Co-Managed by a Specialist - Indicates if the patient has every been seen by a specialist for the HCC category.
Date First Recaptured in Current Year - First date the code was captured in claims in the current year (based on the year selected in filter)
Recapturing Provider NPI - Provider NPI that triggered the recapture in the current year.
Recapturing Provider Name - Provider Name that triggered the recapture in the current year.
Recapturing Provider Specialty - The specialty description of the recapturing provider.
Recapturing Provider Taxonomy Code - The taxonomy description of the recapturing provider.
Date of Last Billing Diagnosing Provider - The date of the most recent billing that included the HCC category on the row. This includes all provider type codes which could include radiology, lab, mammogram.
Last Diagnosing Provider NPI - NPI of the diagnosing provider.
Last Diagnosing Provider Name - Name of the diagnosing provider.
Last Diagnosing Provider Specialty Code Description - Specialty description of the last diagnosing provider.
Last Diagnosing Provider Taxonomy Code - The Taxonomy code for the the last diagnosing provider,
Date of Last PCP Visit - The date of the patients last visit with a PCP.
Last PCP NPI - The NPI of the provider that qualifies as last PCP visit.
Last PCP Specialty Code Description - The name of the provider that qualifies as last PCP provider.
Last PCP Taxonomy Code - The providers Taxonomy description of the patients most recent PCP visit.

Patient Summary

Population Stats