A guide to HCCs for CMS and HHS
(and how RAF scores relate)

Given the potential impact of Hierarchical Condition Categories (HCCs) on an organization’s bottom line, understanding how they work should be a top priority. But identifying and documenting HCCs at the point of care is just part of the payment puzzle.

Since both the Centers for Medicare & Medicaid Services (CMS) and the Department of Health and Human Services (HHS) use HCCs to help calculate reimbursement rates, it’s also important to know the difference between the two programs.

Not sure that you’re up to speed? Don’t fret. In our latest guide, you’ll learn:

  • Why two different forms of HCCs were developed
  • The similarities and differences between the two programs
  • How Risk Adjustment Factor (RAF) scores are calculated under each program
  • How proper HCC coding can lead to greater reimbursements

Download the guide