RISK ADJUSTMENT 2018 AND RAF SCORES 101

RISK ADJUSTMENT 2018 AND

RAF SCORES 101

Robert Resnik MD MBA

Terminology

? HCC- Hierarchical Condition Categories ? Chronic conditions used to create a risk adjustment methodology (PART A,B,C)

? RX HCC ? Some HCC codes adjust risk due to prescription burden of disease (Part D)

? RAF ? Risk Adjustment Factor

Demographic RAF for Medicare Enrollees

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