Beyond HCC Alerts: How CHRISTUS Health Achieved Adoption and Accuracy

Key Takeaways: 

• CHRISTUS Health sought a scalable, provider-friendly approach to improving Hierarchical Condition Category (HCC) coding documentation across its vast and geographically dispersed provider network.
• Partnering with Premier’s Stanson Heath, the health system implemented CodingGuide, an artificial intelligence (AI)-powered, real-time solution designed to help healthcare providers accurately capture and document HCC codes at the point of care. 
• The move helped transform how the organization approached real-time documentation: CodingGuide helped physicians capture the right condition in the right encounter, improved documentation quality across specialties and laid the groundwork for a more confident, data-informed value-based care strategy. As a result, documentation accuracy and specialist engagement improved, provider burden decreased, and the organization gained a clearer view of population risk — turning coding from a compliance task into a strategic tool for care and operational planning. 

When CHRISTUS Health , a Catholic non-profit health system with more than 600 primary and specialty care locations, first explored an artificial intelligence (AI) solution for Hierarchical Condition Category (HCC) coding, Dr. Timonthy Barker, System Medical Director at CHRISTUS Health, was skeptical.

As both a practicing family medicine physician and Chief Medical Information Officer for Ambulatory Informatics at CHRISTUS, Dr. Barker carried the weight of a familiar frustration: providers drowning in pop-up alerts that offered little relevance, added no value and interrupted moments that mattered. The last thing his 15,000-physcian network needed was another nudge, another modal window, another “reminder.”

“I was reluctant to add another interruptive alert that our physicians have to deal with,” Dr. Barker said. “I wanted to make HCC coding as easy and efficient as possible.”

With thousands of providers spread across multiple regions, ensuring accurate documentation of complex conditions while supporting value-based care and minimizing workflow disruption was a challenge. Despite robust clinical programs and dedicated care coordination, CHRISTUS providers were experiencing alert fatigue, workflow interruptions and administrative burden. Existing tools often produced irrelevant alerts, created unnecessary work and/or failed to integrate seamlessly into daily workflows.

From “Not Another Alert” to “This Is What We Needed”

In 2024, CHRISTUS partnered with Premier’s Stanson Health to implement CodingGuide, an AI-powered, real-time solution designed to capture and document HCC at the point of care. Unlike traditional recapture-based tools, CodingGuide uses an advanced revalidation approach that both strengthens recapture and identifies evidence of suspected conditions. It helps providers ensure HCC coding accurately reflects the patient’s current clinical status by evaluating provider notes in real time, highlighting conditions that meet MEAT criteria (Monitored, Evaluated, Assessed/Addressed, Treated), and delivering highly specific, patient-level coding suggestions. 

Moreover, the system is designed to be provider-friendly and seamlessly integrated into existing electronic health record (EHR) workflows. In the early evaluation stages, what surprised Dr. Barker most was the accuracy of the CodingGuide alerts. Alerts are highly specific and appear only when relevant, reducing noise and keeping providers engaged.

“Getting rid of the noise is the main thing,” Dr. Barker said. “The alerts are highly specific, which minimizes any false positives. For example, physicians can look at an alert and say, ‘Yes, this patient has diabetes with nephropathy. I should enter that,’ rather than something that is clinically invalid and doesn’t match the patient.”

The Right Alert, for the Right Provider, at the Right Moment

CHRISTUS is a geographically dispersed health system. Clinics range from large, multispecialty centers to tightly staffed rural practices, and workflows differ accordingly. In this context, even a well-designed digital alert can become a burden if it repeats, duplicates or conflicts with the EHR’s narrative prompts. 

CodingGuide’s deep integration within Epic, CHRISTUS’ EHR software, helped it to avoid this issue. 

“I haven’t heard any complaints,” Dr. Barker said. 

Rather than relying on old visits, outdated codes or passive documentation from weeks earlier, CodingGuide reads the current encounter: the note being written, the assessment being made and the clinical story unfolding in real time. This helps providers recognize each suggestion as a natural extension for the care they are already delivering. 

“Moving toward automation has been a huge win for efficiency,” said Jeannine Bumford, Director of Risk Adjustment Operations at CHRISTUS Health.

Engaging Providers and Building Trust

For CHRISTUS Health, success depends on provider confidence. That’s why, to encourage adoption, Bumford, led a multi-layered education program:

• In-person field visits, lunch-and-learns, and dinner events with physicians.
• Interactive webinars and recordings for flexible learning.
• Specialty-focused alerts to ensure that neurologists, pulmonologists and endocrinologists only see relevant prompts.
• Resident program engagement to instill best practices from the ground up.
• Collaboration with ministry and practice leaders to reinforce adoption.

“Physician champions are critical,” Bumford said. “When your leaders are invested, providers trust the alerts, and that trust drives results.”

Specialists became increasingly engaged as well. While primary care remained the foundation for chronic condition coding, specialists contributed subtler, diagnosis-specific insights that might otherwise have gone unrecognized. Joint training sessions encouraged collaboration and shared accountability across teams, creating a culture in which accurate documentation became a shared responsibility rather than an individual burden.

Aligning Incentives with Performance

CHRISTUS aligned incentives with documentation performance. Providers are evaluated on the percentage of patients for whom all high-risk diagnoses — both refresh and suspected — are addressed. Only when all relevant conditions are documented or marked “not applicable” does a patient count toward their performance numerator.

Thresholds are set at 80 to 85 percent completion, balancing achievable goals with the fact that new high-risk diagnoses continuously enter the denominator. High-performing providers may reach 95 percent compliance, making them eligible for shared savings distributions and quality-based incentives.

“Automation doesn’t replace clinical judgment — it enhances it,” Bumford explained. “Our providers focus on what matters most, and the system supports them in getting there.”

Results: Transforming Coding from a Burden to Strategic Asset

Not long after go-live, Dr. Barker sensed a shift he hadn’t expected. The alerts he once feared would frustrate providers were instead helping them work more accurately, more efficiently and with less cognitive load. In parallel, the trust he once doubted the system could earn was now being built, encounter by encounter. 

Since deployment, CHRISTUS has achieved notable results:

• High-confidence alerts ensure providers only act on relevant suggestions, minimizing false positives.
• HCC refresh and suspected condition follow rates are consistently high, improving risk-adjusted reporting accuracy.
• Provider adoption is strengthened through targeted education, leadership engagement and incentive alignment.
• Specialist engagement ensures comprehensive documentation even for patients with limited primary care touchpoints.

“This system turned coding from a burden into a strategic tool,” said Dr. Barker. “Providers understand how it supports care quality, risk adjustment and workflow efficiency.

“Could we have done this alone? Possibly, but not at this scale or with this level of provider confidence. Premier has been a true partner in transforming clinical integrity across our system.”

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