HCC/RxHCC Risk Tutorial for SETMA Table of Contents - Setma.com

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The following displays the HCC/RxHCC coefficient aggregates for all payers contrast withthe distribution of E&M Codes. This is a good control on Medicare Fee-for-Service andMedicare Advantage.48
Summary:The correlation between HCC/RxHCC coefficient aggregates is not proved and it is notsupported by CMS policy. It is a new idea, which I think has benefit in our understandingof risk and reward.Because HCC/RxHCC now has validity beyond Medicare Advantage, contrasting ACO,MA, and Medical Home populations – which in the future will probably become the samepopulation – helps us make sure that our management of these patients is the same.49
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