HCC Risk Adjustment Model Analysis

[JDoyle_RBI]

I'm building support for the CMS HCC Risk Adjustment Model into an Azure Cloud data warehouse and was interested to know if there are any useful resources that I could leverage to get a head start on this effort? 

[swyatt]

I don't know about resources that can help you get a head start, but from the standpoint of developing HCC risk adjustment tools or RA support tools in SAS, I can tell you that the greatest blind spot is industry knowledge. Any tool or system that you create to interface with the CMS model(s) or CMS reports requires extensive knowledge of the various CMS methodologies and appropriate application. There are potential pitfalls around every corner, and SMEs on the methodologies are hard to find. There are plenty of people in RA jobs that *should* be SMEs on the methodologies, but aren't, and a hefty number of those are quick to give you an ear full of BS that will send you on an endless number of wild goose chases. Most SMEs in RA methodologies that I have encountered are pretty tight-lipped, so it can be a difficult space to navigate. When you find one, keep them close at hand... definitely bring them baked goods on the regular.

[JDoyle_RBI]

Thanks for the feedback. Really there are some good tools/toolkits out there to assist, we understand the models/methodologies quite well, were interested to know if SAS has any insights that we might take advantage of as a new SAS Partner.

I'm always interested to network with the community of users/technology specialists to explore what's working, what's not in the market.

Best regards,

Jim

E: jim.doyle@refinedBI.com