PPT-Risk Adjustment Hierarchical Condition Categories

HCC Coding Payment Model General Education Guide 1 What is CMSs Hierarchical Condition Categories Medicare Risk Adjustment payment model introduced by the Centers for Medicare and Medicaid CMS in 2004. Colorado Division of Insurance. Risk Adjustment Question. Who should administer Risk Adjustment in Colorado?. Federal Government; or. State Government:. Use Federal Model (2012 Exchange Bill says to “strongly consider”). Socioeconomic Status;. Linking Cost and Quality Measures. HSCRC . Performance Measurement . Workgroup. May 28, 2014 . Tom Valuck, MD, JD. Presentation. . Overview. U. pdate . the . Performance Measurement Workgroup . Socioeconomic Status;. Linking Cost and Quality Measures. HSCRC . Performance Measurement . Workgroup. May 28, 2014 . Tom Valuck, MD, JD. Presentation. . Overview. U. pdate . the . Performance Measurement Workgroup . A Work Plan for State Officials. December 2, 2011. Ross Winkelman, FSA Mary Hegemann, FSA and Syed Mehmud, ASA. Contributions by Tom Leonard, James Woolman, Julie . Peper. , and Patrick Holland. Caveats. An Introduction and Discussion. MAPAM. March 16, 2017. Agenda. Risk Adjustment . How Risk Adjustment Works. Risk Adjustment Factor (RAF) Scoring Process. Comprehensive Annual Visits. Predictive Modeling & Quality of Care. Association of Clinical Documentation Improvement Specialists. Indiana Chapter. Indianapolis, IN. April 21, 2018. What are HCCs?. Risk adjustment system based on diagnosis codes. HHS-HCCs. ACA plans. Risk adjustment. Program establish by Centers for Medicare and Medicaid Services [CMS]. GOAL. : to allocate resources to those patients who most need them, based on each patient’s severity of illness. Date:. 2013-09-15. Authors:. Name. Affiliations. Address. Phone. Email. Hui. Zhao. BUPT. hzhao@bupt.edu.cn. Juwo. Yang. BUPT. yangjuwo@163.com. Giuxia. Kang. BUPT. gxkang@bupt.edu.cn. Wei. xia. . Momen Wahidi, MD, MBA. Dev Sangvai, MD, MBA. The Shift to Value-Based Care. Market is increasingly shifting toward population health (value-based) contracts. In order to be eligible for incentive payments and avoid penalties, providers must meet . Alice B. Torrez MHA, CPC. Educator Coding and Documentation. Health Information Management. University of New Mexico Hospital. 2. View of Risk Adjustment. Are my patients . sicker?. These numbers are not right…. Recovered memories. : Memories, . typically of traumatic experiences . that have been forgotten to be retrieved later.. Loftus. : No such thing as recovered memories.. Current thinking. : Some recovered memories are real, but many may be false.. Does . your . plan’s strategy violate the False Claims Act?. Phillips & Cohen LLP. www.phillipsandcohen.com. 2. Overview of Risk Adjustment Fraud. Risk adjustment fraud is essentially “upcoding” for diagnosis codes. 2016. Risk Adjustment and Hierarchical Condition Category (HCC) Coding . Mandated by the Centers for Medicare and Medicaid Services (CMS) in 1997.  . Model assigns a risk factor score to individuals with serious or chronic illness based upon a combination of the individual’s health conditions (ICD-10) and demographic details.. Linking Cost and Quality Measures. HSCRC . Performance Measurement . Workgroup. May 28, 2014 . Tom Valuck, MD, JD. Presentation. . Overview. U. pdate . the . Performance Measurement Workgroup . on NQF .