Created by CMS in 1997, HCC or “Hierarchical Condition Category” is a risk adjustment model to calculate risk scores for Medicare beneficiaries. HCC scores reflect expected annual medical …

Aug 25, 2025 · As healthcare shifts to value-based care, accurate HCC coding and RAF scoring are vital for reimbursement and compliance. This guide highlights best practices, challenges, …

Apr 29, 2025 · Master risk adjustment coding and learn how accurate RAF scores and HCC capture can improve reimbursement and value-based care.

Our RAF Score Calculator performs distinct calculations for RISK scores and Medicare Advantage Payment across demographics, diagnoses, and disease interactions.

RAF Score Calculator to accurately calculate patient risk scores based on medical conditions, demographics, and other factors for healthcare providers and payers.

Discover the role chronic conditions play in overall risk adjustment, how the risk adjustment factor (RAF) score is calculated, and how the cumulative RAF score for covered beneficiaries drives …

Calculates real-time, patient-level RAF score. Allows user to filter patients by RAF, provider or insurance. Provides an HCC dashboard for trending analysis, enabling comparison of RAF …

Learn how to use HCC RAF Score tools to get an accurate Medicare HCC RAF score using a web interface and REST API to integrate with any third-party apps.

Use this calculator to see how various demographics and patient conditions affect a person's risk score. Note: not all interactions will cause the risk score to change.

Every year, a beneficiary’s Risk Adjustment Factor (RAF) score is calculated based on their assigned HCCs. A RAF or risk score >1 indicates above average risk and a RAF or risk score …