Accurate risk adjustment isn’t just a box to check; it’s now a strategic lever. Hierarchical Condition Category (HCC) coding underpins risk scores that drive Medicare Advantage and other value-based ...

Claims data, which form the foundation of risk adjustment in payment for health care services, may reflect efforts to capture more—or more severe—clinical conditions rather than true changes in health ...

Accurate HCC coding is critical for patient risk adjustment, as it directly impacts reimbursement models and financial sustainability in value-based care. However, studies indicate that as many as ...