CMS is pleased to announce the availability of Medicare Risk Score Research Identifiable Files (RIFs) for Payment Year 2014 (PY14). Risk scores are used to adjust payments to Medicare Advantage plans to account for differences in relative costs among plan enrollees. The risk score RIFs are created from the final CMS risk adjustment model processing run outputs for the payment year, and include a base file which contains payment scores, which are risk scores that have been adjusted in several ways to account for cost considerations when used to adjust plan payments. In addition, the base file contains monthly “resolved” payment scores, where the payment score for the model segment applicable to a beneficiary for a given month of the payment year is identified.
In addition to the base risk score file, the PY14 RIFs include the Model Output Files (MOFs), which contain the raw model scores unadjusted for payment purposes, as well as the Hierarchical Condition Categories (HCCs) applicable to each model segment. For PY14, there are 4 Part C MOF files and 1 Part D MOF file. All RIFs contain beneficiary-level records that can be linked to other Research Identifiable File (RIF) data via the CCW beneficiary identifier, the Bene_ID. The PY14 Risk Score RIFs can be requested through the usual RIF process, found on the Research Data Assistance Center (ResDAC) website.