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Risk adjusment models and parameters for medicare advantange rates and prescription drug rates. Centers for medicare & medicaid services (cms) is updating its patient risk scoring system in 2024 in a way that will change payments that are based on hierarchical condition category (hcc). Hierarchical condition categories (hccs) which is cms’ risk adjustment reimbursement methodology for medicare advantage (ma) (medicare part c) has undergone a significant overhaul for cy 2024 in the form of the release of a new model version.
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This memo is to inform plan sponsors of system changes that will take effect in january 2024. The 2024 version brings significant modifications to the hierarchical condition category (hcc) codes compared to the 2020 version.
