Risk score calculator

Real classification logic. Your own coefficients.

CMS-HCC risk adjustment sorts each patient into a demographic segment (community non-dual aged, institutional, new enrollee, etc. — CMS's actual category codes), then sums a demographic factor with disease-category factors. A condition's more-severe HCC excludes its milder version via an explicit exclusion list — not "pick the bigger number" — so it isn't double-counted.

The demographic-segment logic and the exclusion-list hierarchy mechanism below are copied from an actual open-source healthcare-data dbt project's CMS-HCC model. Its own coefficient seed tables ship empty in that project too — CMS's official rate-table numbers aren't redistributable — so the numbers below are clearly-marked placeholders for you to replace with official CMS Rate Announcement values, exactly as that project requires. Runs entirely in JavaScript — no model download.

Patients

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Headers just need to resemble the sample below — exact wording isn't required.

Demographic factor seed (PLACEHOLDER — not real CMS values)

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Headers just need to resemble the sample below — exact wording isn't required.

Disease/hierarchy seed (PLACEHOLDER — not real CMS values)

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Headers just need to resemble the sample below — exact wording isn't required.