The ceriskscore table stores computed risk scores for each person at monthly intervals. The risk score is computed from Hierarchical Condition Categories (HCC) summarized in the hccprofile table.
While the algorithm to compute the risk score is based on the CMS RAPS risk adjustment algorithm, these risk scores are computed in monthly intervals (up to the current month; this is in contrast to the CMS algorithm which computes the score only in historical reporting periods) in order to support real-time care management use cases. In addition, CE has extended the CMS population segment and demographic components in order to apply the model to persons of all ages and beneficiary statuses (including commercially insured populations).
See also: Condition Profiles and Risk Score
Usage
Filter this table using ceriskscore.period = 0 in order to obtain the current risk score for each person in the table. Filter this table using ceriskscore.enddate to obtain the risk score that would have been computed in a prior month. Use all rows in order to trend risk scores over time.
Determine the HCCs used to compute the risk score by using the hccprofile table or the related personhcc table.
Source Concepts
Table Schema
| Name |
Type
|
Description |
| personid |
VARCHAR (GUID) |
Unique identifier representing a unique person that may include data from several sources that have been linked. This identifier is the person_id of a HIEBus recordgroup.
|
| enddate |
TIMESTAMP |
The end date of the period for which the risk score is calculated.
|
| period |
INTEGER |
The difference in months between the enddate and the current month. The most recently calculated risk score (for the current month) will be indicated by period=0. The risk score for the previous month will be indicated by period=1; two months ago by period=2, etc.
|
| riskadjustmentmodel |
VARCHAR |
The algorithm used to specify HCCs, their value sets, and their weights. For example: CMS-HCC Part C v23
|
| riskadjustmentsegment |
VARCHAR |
The beneficiary group for the person, used to determine the coefficients assigned to the HCCs. For example: New Enrollee, Continuing Enrollee, Disabled, etc.
|
| demographicscore |
DECIMAL |
The component of the risk score that is based on age and gender computed for the person in the specified period (that is, using age computed at the specified end date).
|
| conditionscore |
DECIMAL |
The component of the risk score that is based on diagnoses data computed for the person in the specified period (that is, using diagnoses data detected on or before the specified end date). This is computed using the summed coefficients for active HCCs and condition interaction coefficients as specified by the algorithm.
|
| riskscore |
DECIMAL |
The risk score computed for the person in the specified period (that is, using diagnoses data detected on or before the specified end date). Generally this is a sum of the demographicscore and conditionscore.
|
| umscore |
DECIMAL |
The sum of the coefficients for HCCs identified as unmanaged (that is, chronic AND documented historically BUT without a diagnoses in the past 365 days).
|
| deltariskscore1m |
DECIMAL |
The change in the risk score between the current period and the prior 1 month.
|
| deltariskscore2m |
DECIMAL |
The change in the risk score between the current period and the prior 2 months.
|
| deltariskscore3m |
DECIMAL |
The change in the risk score between the current period and the prior 3 months.
|
| deltariskscore6m |
DECIMAL |
The change in the risk score between the current period and the prior 6 months.
|
| deltariskscore12m |
DECIMAL |
The change in the risk score between the current period and the prior 12 months.
|
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