RISK ADJUSTMENT 2018 AND RAF SCORES 101
[Pages:83]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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