Details
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Change Request
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Resolution: Persuasive
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Highest
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US Da Vinci Risk Adjustment (FHIR)
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0.1.0 [deprecated]
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Clinical Quality Information
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Da Vinci Risk Adjustment Implementation Guide Home Page
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1.3.2 Moddel Hierarchies
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Yan Heras/Floyd Eisenberg: 17-0-1
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Clarification
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Non-substantive
Description
"When a disease hierarchy is applied it changes CCs into Hierarchical Condition Categories (HCCs) with less severe HCCs superseded (ignored) if evidence of higher severity HCCs is present." This is not quite accurate since risk assessment and risk prediction would supercede conditions in the same category set but not ignore other categories. For example insulin dependent diabetes would supercede non-insulin dependent diabetes (NIDDM); however, the addition of non-insulin dependent diabetes would not ignore the condition of depression. In fact, as I recall, a HCC example from some years ago was that NIDDM plus depression HCC categories had approximately four times the annual coverage cost compared to the same NIDDM classification without depression. Recommend clarification for those entering this aspect of healthcare.
Attachments
Issue Links
- is voted on by
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BALLOT-27365 Affirmative - Linda Michaelsen : 2022-Jan-FHIR IG RA R1 STU
- Closed
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BALLOT-28561 Affirmative - Will Winterer : 2022-Jan-FHIR IG RA R1 STU
- Closed
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BALLOT-28573 Affirmative - Kevin Larsen : 2022-Jan-FHIR IG RA R1 STU
- Closed
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BALLOT-28585 Affirmative - Sheila Connelly : 2022-Jan-FHIR IG RA R1 STU
- Closed
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BALLOT-28597 Affirmative - Michelle Miller : 2022-Jan-FHIR IG RA R1 STU
- Closed