What is the value assigned to each HCC in a payment model called?

What is the value assigned to each HCC in a payment model called?

• A. Payment Index
• B. Risk Adjustment Factor
• C. Severity Score
• D. Reimbursement Unit

Answer: (B)

In HCC-based payment models, the weight assigned to each diagnosed condition is called the risk adjustment factor. This factor represents the expected healthcare cost impact of that condition and, when summed across all of a patient’s HCCs (plus any demographic adjustments), forms the patient's overall risk score used to adjust payments. A severity score describes how serious an individual condition is, but it isn’t the aggregate weight used to price a patient’s care in this model. The terms payment index and reimbursement unit aren’t the standard weights used for HCCs in determining risk-adjusted payments.

In HCC-based payment models, the weight assigned to each diagnosed condition is called the risk adjustment factor. This factor represents the expected healthcare cost impact of that condition and, when summed across all of a patient’s HCCs (plus any demographic adjustments), forms the patient's overall risk score used to adjust payments. A severity score describes how serious an individual condition is, but it isn’t the aggregate weight used to price a patient’s care in this model. The terms payment index and reimbursement unit aren’t the standard weights used for HCCs in determining risk-adjusted payments.