Case Study: Renowned Healthcare Services Company achieves 80% coding-gap closure and accelerated Medicare Advantage risk adjustment with Innovaccer's FHIR Data Activation Platform (InNote)

Transforming Risk Adjustment and Star Ratings Performance for a Medicare Advantage Plan

Renowned Healthcare Services Company faced slow, manual clinical documentation improvement (CDI) workflows that relied on paper alerts and could take up to two weeks for providers to receive feedback, hampering risk adjustment and Medicare Advantage Star Ratings performance. To replace this inefficient process and integrate with provider EMRs, the customer engaged Innovaccer and adopted Innovaccer’s FHIR-enabled Data Activation Platform along with the InNote point-of-care insights solution.

Innovaccer implemented bidirectional, FHIR-based interoperability (InAPI) and in-workflow InNote alerts to deliver CDI insights directly on clinicians’ EHR screens, digitizing CDI alerts, progress notes, and coder queries. The result: 80% of coding gaps closed, 100% of gaps flagged at the point of care, an 80% reduction in chart retrieval time, turnaround cut from two weeks to days, 400+ ICD/CPT/HCPC codes enabled for reporting, 100% additional data found for attributed members, and 99%+ API uptime—delivering rapid, measurable savings and improved risk-score accuracy.