Hierarchical Condition Category (HCC)

Hierarchical Condition Category 

Hierarchical Condition Category (HCC) is a risk adjustment model utilized to estimate predicted costs for beneficiaries based on disease and emographic risk factors, leading to increased payments for high-risk patients. Inaccurate reporting of chronic and acute conditions and their associated HCC diagnosis codes may lead to significant foregone care delivery and revenue opportunities. Risk-adjusted and value-based models are the future of reimbursement, for both commercial and government payers.

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