Model change impact on the Medicare Advantage 2020 RxHCC risk scores

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By Adrian L. Clark, David Koenig | 23 May 2019
The 2020 Rate Announcement released by the Centers for Medicare and Medicaid Services in April includes details for the 2020 Medicare Part D pharmacy hierarchical condition categories risk score model. This paper summarizes the changes in member risk scores resulting from the risk score model update and quantifies the model change using three separate metrics: the change to the model coefficients, the overall change in risk score for a nationwide population by key enrollee characteristics, and the change to the normalization factor.