The difference between the CMS HCC and the RxHCC models is in the potential expenditure. Each model calculates total expenditures, which in the CMS-HCC model are medical services, and in the RxHCC model, the expenditures are reflective of:
A) medical expenditures.
B) prescription drug costs.
C) comorbid conditions.
D) complexity of diagnoses.

Question

Quizplus · Accepted Answer

The CMS-HCC (Hierarchical Condition Category) model calculates total expenditures based on medical services, while the RxHCC (Prescription Drug Hierarchical Condition Category) model focuses on expenditures related to prescription drug costs.

The Difference Between the CMS HCC and the RxHCC Models