Smarter Documentation, Smarter Care: How Tampa General Hospital Overhauled Its Approach to HCC Coding

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Key Takeaways

• Tampa General Hospital (TGH) recognized that traditional documentation and hierarchical condition category (HCC) coding workflows could not fully capture the complexity of their high-acuity patient population.
• By implementing Premier's Stanson Health CodingGuide, TGH embedded real-time, patient-centered insights directly into their Epic workflows.
• The results have been transformative: TGH achieved a 74 percent follow rate with minimal overrides (3 percent) and higher provider engagement, significantly outperforming peer benchmarks.

As one of Florida's leading academic health systems, Tampa General Hospital (TGH), in partnership with USF Health Morsani College of Medicine, provides care to more than six million residents across 15 counties. Anchored by a 982-bed academic medical center in Tampa, the private, not-for-profit health system is home to the region's only Level I trauma center and one of the nation's top organ transplant programs. TGH delivers world-class, academic care for some of the most complex and critically ill patients in the country, serving as a cornerstone of world-class care for West Central Florida.

As healthcare delivery continues to evolve, so, too, do the demands placed on hospitals such as TGH. Many of TGH's patients require highly specialized services, which makes comprehensive and precise documentation critical not only for clinical decision-making but also for meeting the requirements of value-based care (VBC) contracts and risk-adjusted reimbursement models. Recognizing the need for smarter, more efficient approaches to documentation, TGH partnered with Premier's Stanson Health.

"We provide quaternary care to some of the most complex patients in Florida," said Dr. Joanna Ramirez, Medical Director of ACO and Population Health at Tampa General Medical Group. "Yet, we struggled to make sure our documentation painted the right clinical picture. We knew we needed a smarter, more integrated approach."

Driving Provider Engagement and Accuracy

Accurate Hierarchical Condition Category (HCC) coding is essential for providers participating in VBC. By capturing the severity and complexity of patient conditions, HCC directly impacts risk-adjusted reimbursement under Medicare and other payers. Traditional coding processes, however, can be time-consuming and error-prone, leading to missed or inaccurate codes that affect both reimbursement and patient care.

Among its goals, TGH sought to:

• ​Identify the right technology that could make its goals a reality and work seamlessly ​with its clinical documentation improvement (CDI) team and electronic health record (EHR).
• Improve risk adjustment factor (RAF) scores, streamline provider-CDI workflows, capture the most accurate clinical picture of at-risk ​VBC populations​ and maximize shared savings.
• Ensure accurate HCC coding​.
• Implement a comprehensive, end-to-end HCC solution (pre-encounter, point-of-care and post-encounter)​.
• Deepen and elevate Epic integration for seamless workflows.

In July 2025, TGH worked with Premier to launch its HCC solution, CodingGuide, for primary care providers, embedding artificial intelligence (AI)-driven, actionable insights directly into TGH's EHR, Epic. The solution recognizes that clinical conditions evolve, patients change and diseases progress or improve year over year. CodingGuide introduces an inference, recapture, and revalidation tool that meticulously examines EHRs and clinical notes, ensuring that HCC codes accurately reflect the current state of a patient's health.

"The success of our partnership with Premier depended on their ability to coordinate across sites, align workflows to drive product value and seamlessly integrate those workflows into daily operations," Dr. Ramirez said.

Premier engaged key stakeholders across TGH's three distinct provider groups through multiple meetings, aligning priorities, customizing outreach and clearly communicating the specific benefits each group would gain. Implementation was deliberately phased to meet teams where they already worked rather than forcing change. It also maintained flexibility and delivered exactly what each group required.

"Our primary care providers see complex patients in 15- to 30-minute visits," Dr. Ramirez said. "Premier's AI-powered solution reviews both structured and unstructured data in real time. That second set of eyes means we're not missing important HCC opportunities, and we're doing it compliantly."

Early Successes and Measurable Impact

CodingGuide's integration into Epic ensures real-time, encounter-wide visibility with no extra steps for providers - and the results have been tangible. Since launch, TGH has seen improvements in both provider efficiency and clinical documentation accuracy:

• Exceptional follow rate: 74 percent follow rate as of Sept. 15, 2025 - among the highest across all Epic organizations.
• Minimal overrides: Only 3 percent override rate, demonstrating strong provider confidence in the guidance.
• Low ignore rate: Only 23 percent ignored alerts, reflecting high engagement.
• Outstanding HCC obesity performance: 81 percent follow rate for HCC Obesity V28, nearly 20 points above benchmarks at other Premier customer organizations.

"The quality of insights was transformative," Dr. Ramirez noted. "We didn't want generic alerts. We needed patient-specific guidance that made sense in the moment. CodingGuide gave us exactly that." The synergy between Premier and Epic's HCC capabilities lay at the core of these results. Premier's natural language processing (NLP) and machine learning (ML) can extract essential clinical details from provider notes. This, in turn, supports more comprehensive, compliant and precise coding while maintaining efficiency.

"Premier's workflow complemented our Epic foundational HCC content," said Dr. Ramirez. "We could tap into both structured and unstructured data to avoid missing opportunities while documenting compliantly with MEAT (Monitor, Evaluate, Assess, Treat) criteria.

"We aimed for full, ambulatory V28 category coverage. Epic provides some identification, but the (added) ability to recapture and infer new suspects within each category was really important. The AI-generated clinical summaries that explain conditions to our CDI team and providers have been a game changer (because) they make our coders more efficient. With only six coders across our entire ambulatory system, expanding their reach to more patient encounters has been invaluable."

Beyond HCC technology, TGH explored ambient listening and AI-powered scribe tools to reduce administrative burden. These tools capture and summarize patient encounters automatically, letting clinicians focus on care rather than charting.

"Less charting, more caring - that's the goal," said Dr. Ramirez. "With ambient listening and Premier working together, our providers spend more time with patients and less time documenting."

Seamless Integration, Smarter Workflows

TGH's collaboration with Premier is far from a one-off event: It's a continuous partnership. Regular meetings between clinical, IT and operational teams ensure that workflows are updated, insights remain clinically relevant, and the tools continue to adapt to the organization's evolving needs.

"Our goal is to capture the most accurate clinical picture for every patient we see," said Dr. Ramirez. "With Premier, we're not just improving coding - we're improving how we care for our patients."

Looking forward, TGH has plans to leverage CodingCare, which builds upon CodingGuide by actively involving coders and documentation improvement specialists in both pre- and post-encounter documentation.

"The partnership has been everything," Dr. Ramirez said. "Premier didn't just hand us a product - they worked side by side with our Epic team, our CDI team and our clinicians to make sure it really fit. That's what made it successful."

For more:

• Learn about what a partnership with Premier's Stanson Health can do for your healthcare organization.