How Does An HCC Work?
The CMS-HCC model uses diagnoses from physician visits and hospital inpatient and outpatient stays in order to assign an HCC category to a beneficiary. It may range from none assigned to one or several. For example, an MA enrollee with chronic heart disease, cerebrovascular disease, and cancer will reflect increments for each of these conditions.
The CMS-HCC model uses diagnoses from physician visits and hospital inpatient and outpatient stays in order to assign an HCC category to a beneficiary. It may range from none assigned to one or several. For example, an MA enrollee with chronic heart disease, cerebrovascular disease, and cancer will reflect increments for each of these conditions.