CMS-HCC Demographic Coefficient |
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The table below shows Demographic coefficients defined in the risk adjustment model in the specified payment year. The demographic information includes beneficiary facts, such as age and sex, and includes certain beneficiary status indicators that enable grouping into similar segments, such as those living in the community versus an institution. CMS-HCC risk adjustment models are applied to the community non-dual aged, community non-dual disabled, community full benefit dual aged, community full benefit dual disabled, community partial benefit dual aged, community partial benefit dual disabled, and institutional.
| Demographic Category Description | Community, NonDual, Aged | Community, NonDual, Disabled | Community, FBDual, Aged | Community, FBDual, Disabled | Community, PBDual, Aged | Community, PBDual, Disabled | Institutional |
|---|---|---|---|---|---|---|---|
| Female, 0-34 Years | 0.000 | 0.238 | 0.000 | 0.346 | 0.000 | 0.454 | 0.948 |
| Female, 35-44 Years | 0.000 | 0.288 | 0.000 | 0.332 | 0.000 | 0.420 | 0.810 |
| Female, 45-54 Years | 0.000 | 0.340 | 0.000 | 0.384 | 0.000 | 0.404 | 1.031 |
| Female, 55-59 Years | 0.000 | 0.385 | 0.000 | 0.421 | 0.000 | 0.424 | 0.949 |
| Female, 60-64 Years | 0.000 | 0.436 | 0.000 | 0.502 | 0.000 | 0.414 | 0.881 |
| Female, 65-69 Years | 0.330 | 0.000 | 0.435 | 0.000 | 0.365 | 0.000 | 1.188 |
| Female, 70-74 Years | 0.395 | 0.000 | 0.506 | 0.000 | 0.423 | 0.000 | 1.119 |
| Female, 75-79 Years | 0.465 | 0.000 | 0.596 | 0.000 | 0.485 | 0.000 | 0.965 |
| Female, 80-84 Years | 0.524 | 0.000 | 0.665 | 0.000 | 0.544 | 0.000 | 0.862 |
| Female, 85-89 Years | 0.624 | 0.000 | 0.775 | 0.000 | 0.618 | 0.000 | 0.750 |
| Female, 90-94 Years | 0.737 | 0.000 | 0.869 | 0.000 | 0.738 | 0.000 | 0.627 |
| Female, 95 Years or Over | 0.742 | 0.000 | 0.877 | 0.000 | 0.835 | 0.000 | 0.481 |
| Male, 0-34 Years | 0.000 | 0.106 | 0.000 | 0.191 | 0.000 | 0.306 | 0.826 |
| Male, 35-44 Years | 0.000 | 0.154 | 0.000 | 0.204 | 0.000 | 0.261 | 0.719 |
| Male, 45-54 Years | 0.000 | 0.215 | 0.000 | 0.293 | 0.000 | 0.300 | 0.991 |
| Male, 55-59 Years | 0.000 | 0.283 | 0.000 | 0.410 | 0.000 | 0.353 | 0.989 |
| Male, 60-64 Years | 0.000 | 0.345 | 0.000 | 0.504 | 0.000 | 0.374 | 0.917 |
| Male, 65-69 Years | 0.332 | 0.000 | 0.531 | 0.000 | 0.375 | 0.000 | 1.275 |
| Male, 70-74 Years | 0.396 | 0.000 | 0.626 | 0.000 | 0.417 | 0.000 | 1.224 |
| Male, 75-79 Years | 0.502 | 0.000 | 0.714 | 0.000 | 0.498 | 0.000 | 1.319 |
| Male, 80-84 Years | 0.571 | 0.000 | 0.789 | 0.000 | 0.565 | 0.000 | 1.238 |
| Male, 85-89 Years | 0.664 | 0.000 | 0.907 | 0.000 | 0.615 | 0.000 | 1.135 |
| Male, 90-94 Years | 0.800 | 0.000 | 0.993 | 0.000 | 0.712 | 0.000 | 0.946 |
| Male, 95 Years or Over | 0.896 | 0.000 | 1.058 | 0.000 | 0.904 | 0.000 | 0.825 |
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