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BC Advantage - 2018 Issue 7

Risky Business The CMS HCC Risk Model

Today's catchy title may invoke memories of that risqué movie from the 80's starring a young Tom Cruise famously dancing in his "tighty whities." But today's post is not about that type of risk. Instead we are going to spend some time with a risk adjustment model that's quietly become an important part of most of the payment programs that nephrologists are involved with today. The name of this program is a mouthful: The Center for Medicare & Medicaid Services Hierarchical Condition Category risk adjustment model, thankfully shortened to CMS-HCC risk adjustment.Medicare Advantage (MA)Before we take a...

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