Risk Adjustment and the ABCs of HCCs

Today on the blog, we are discussing two central questions that directly determine how providers receive their operating revenue: What is risk adjustment? What is hierarchical condition category (HCC) coding? Risk adjustment alters the cost of healthcare coverage based on a patient’s health status. The payments are adjusted according to the patient’s age, disability, financial status, and diagnoses. Hierarchical condition category (HCC) codes leverage ICD-10 codes to document those health statuses. Each chronic condition is assigned a payment value on the care of a patient with that condition. When providers document HCC codes, it allows payers to calculate their risk-adjustment …