3M Health Information Systems Representing the patient burden of illness in a value-based health care worldHow do you capture the patient’s burden of illness in value-based health care? Through an accurate assessment of the patient’s health status using risk adjustment factors (RAF) score. A RAF score is assigned in a risk-adjusted model based on a patient’s demographic factors and diagnosis codes mapped to hierarchical condition categories (HCCs). RAF scores are used as a metric to predict care utilization and financial projection for the following year for patient care. Demographic risk score Disease risk score Patient R AF • Age • Residence (community versus skilled nursing facility (SNF) or institution) • Medicaid disability and interaction with age/gender • Reported HCC diagno

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