adult_interaction

A dataset containing the adult model interaction factors for the risk
adjustment model. Certain HCCs are considered "high risk" HCCs, and when
one of these high risk HCCs interacts with certain other HCCs, an additional
interaction term is added to the risk score.

datasets

Datasets from most recent CCIIO DIY entry
in a tidy format. These support the Centers for Medicare and Medicaid
Services' (CMS) risk adjustment Do-It-Yourself (DIY) process, which allows
health insurance issuers to calculate member risk profiles under the Health
and Human Services-Hierarchical Condition Categories (HHS-HCC) regression
model. This regression model is used to calculate risk adjustment transfers.
Risk adjustment is a selection mitigation program implemented under the
Patient Protection and Affordable Care Act (ACA or Obamacare) in the USA.
Under the ACA, health insurance issuers submit claims data to CMS	in order
for CMS to calculate a risk score under the HHS-HCC regression model.
However, CMS does not inform issuers of their average risk score until after
the data submission deadline. These data sets can be used by issuers to
calculate their average risk score mid-year. More information about risk
adjustment and the HHS-HCC model can be found here:
<https://www.cms.gov/mmrr/Articles/A2014/MMRR2014_004_03_a03.html>.

Ethan Brockmann

edgedata

Datasets that Support the EDGE Server DIY Logic

adult_interaction function

An object of class <code>tbl_df</code> (inherits from <code>tbl</code>, <code>data.frame</code>) with
2 rows and 7 columns<dl class="dl-horizontal">
<dt>int_group</dt><dd>Interaction group (M/H)</dd>
<dt>used</dt><dd>Whether or not the category is used in the RA model</dd>
<dt>plat, gold, silver, bronze, cat</dt><dd>HCC grouping risk score for each
metal level</dd>
</dl>

Format

Adult Interaction Factors - Table 9 — adult_interaction

An object of class <code>tbl_df</code> (inherits from <code>tbl</code>, <code>data.frame</code>) with
2 rows and 7 columns<dl class='dl-horizontal'>
<dt>int_group</dt><dd>Interaction group (M/H)</dd>
<dt>used</dt><dd>Whether or not the category is used in the RA model</dd>
<dt>plat, gold, silver, bronze, cat</dt><dd>HCC grouping risk score for each
metal level</dd>
</dl>

adult_interaction: Adult Interaction Factors - Table 9

Description

Usage

Arguments

Format

See Also