Monthly final, prospective risk score based on the applicable risk adjustment model for the MA payment year corresponding to the report period. Only populated for Final Assignment runs.
Comments
Monthly risk scores are renormalized so that the mean national assignable FFS risk score for the beneficiary's enrollment type in that month (as indicated by the corresponding monthly enrollment flag) equals 1.0. Risk scores for different enrollment categories are renormalized separately; ESRD risk scores are renormalized to the ESRD population, disabled risk scores are renormalized to the disabled population, aged/dual risk scores are renormalized to the aged/dual population, and aged/non-dual risk scores are renormalized to the aged/non-dual population. To obtain renormalized risk scores, CMS divides the beneficiary’s risk score by the mean national assignable FFS CMS-HCC risk score for the applicable enrollment type. Prior to renormalization, the MA coding intensity adjustment is removed from risk scores for all non-ESRD months by multiplying by a factor applicable for that year (provided in the Announcement of Calendar Year MA Capitation Rates and Part C and Part D Payment Policies). Beneficiaries who were not included in the CMS-HCC risk score file will not have CMS-HCC risk score data reported for any months. Beneficiaries who are in the CMS-HCC risk score file but who are missing risk scores for particular months will not have risk scores reported for those months. CMS-HCC risk scores for beneficiaries who are new enrollees are based on demographic factors only, even if those beneficiaries have CMS-HCC flags.
Monthly risk scores are renormalized so that the mean national assignable FFS risk score for the beneficiary's enrollment type in that month (as indicated by the corresponding monthly enrollment flag) equals 1.0. Risk scores for different enrollment categories are renormalized separately; ESRD risk scores are renormalized to the ESRD population, disabled risk scores are renormalized to the disabled population, aged/dual risk scores are renormalized to the aged/dual population, and aged/non-dual risk scores are renormalized to the aged/non-dual population. To obtain renormalized risk scores, CMS divides the beneficiary’s risk score by the mean national assignable FFS CMS-HCC risk score for the applicable enrollment type. Prior to renormalization, the MA coding intensity adjustment is removed from risk scores for all non-ESRD months by multiplying by a factor applicable for that year (provided in the Announcement of Calendar Year MA Capitation Rates and Part C and Part D Payment Policies). Beneficiaries who were not included in the CMS-HCC risk score file will not have CMS-HCC risk score data reported for any months. Beneficiaries who are in the CMS-HCC risk score file but who are missing risk scores for particular months will not have risk scores reported for those months. CMS-HCC risk scores for beneficiaries who are new enrollees are based on demographic factors only, even if those beneficiaries have CMS-HCC flags.