The Centers for Medicate and Medicaid (CMS) developed the Hierarchical Condition Categories (HCC) to calculate risk scores and adjust capitation payments made for beneficiaries enrolled in Medicare Advantage (MA) plans. The CMS Risk Adjustment Model includes nearly 80...
There is an increasing focus on the quality of care, whether its prevention, early diagnosis of illness, or therapeutic services. HEDIS ((Healthcare Effectiveness Data and Information Set), created by NCQA (National Committee for Quality Assurance) grew of the need to...
