CMS implemented the Hierarchical Condition Categories (HCC) model in 2004 to adjust capitation payments to Medicare Advantage plans for the health expenditure risk of their enrollees.
CMS' Risk Adjustment materials include a lot of information such as HCC, RxHCC, HCC ESRD, and HCC PACE risk adjustment model documentation, coefficients, and other source materials. including a worked example.
Condition Category to ICD crosswalk files are also available.
Prescription drug Hierarchical Condition Category (RxHCC) info is available beginning 2006.
End-Stage Renal Disease (ESRD) and Program of All-Inclusive Care for the Elderly (PACE) info is avaialable starting 2012.
A collection of data sets of ICD9 titles is available.
The SAS, Stata, and CSV files are offered here with uniform file names and variable names to make the ICD HCC crosswalks a bit easier to use.
So, January 1 - September 30, 2015, ICD-9-CM codes were used,
and October 1, 2015 - December 31, 2015 ICD-10-CM codes are used.
To report errors, or if you have comments or suggestions, e-mail firstname.lastname@example.org.
|Last Update: March 20, 2018||Created by Jean Roth August 1, 2014|