Hierarchical Conditional Category (HCC) Practice Test

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How are RAF values combined when multiple HCCs are present in the same CY?

They are added together

RAF values are additive when multiple HCCs are present in the same calendar year. Each HCC has a weight that reflects the extra expected costs associated with that condition, and the total RAF for the year is the sum of all those weights. This additive approach captures how having several conditions together increases overall risk. Averaging would understate risk with multiple conditions, multiplying would distort the relationship, and using only the largest would ignore other concurrent conditions that contribute to higher costs. So, the more HCCs a patient has in a year, the higher the total RAF becomes due to the straightforward sum of the individual HCC weights.

They are averaged

They are multiplied

Only the largest RAF is used

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